NPIMap

Individual provider Active NPI

Jyoti Kothavale Sutter, M.D.

  • Internal Medicine Physician
  • Ann Arbor, MI
National Provider Identifier
1336300508
Registry record updated May 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301100057 Issued in MI
Practice address
1500 E Medical Center Dr
3Rd Floor Taubman Center Recp B
Ann Arbor, MI 48109-5352
Phone
(734) 936-5582
NPI assigned
Jun 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 11014173A IN
Internal Medicine Physician 207R00000X 4301100057 MI Primary

Addresses

Primary practice location

1500 E Medical Center Dr
3Rd Floor Taubman Center Recp B
Ann Arbor, MI 48109-5352

Mailing address

3621 S State St
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120803000787 MI Practitioner - Internal Medicine 0042488694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Wayne State University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

128 Van Buren St
Chelsea, MI 48118-1623
Phone (734) 475-8677

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11014173AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Services Corporation Internal Medicine CurrentSince Oct 1, 2016 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Iha Health Service Corporation CurrentSince Oct 1, 2016 Accepting new patients
Iha Health Services Corporation Past Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

14288 E Old US Highway 12
Ste 200
Chelsea, MI 48118
Phone (734) 475-8677

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

5325 Elliott Dr
Ste 203
Ypsilanti, MI 48197
Phone (734) 712-8020

Interoperability endpoints

  • Direct secure messaging: jsutter25918@direct.trinity-health.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336608000000",
    "number": "1336300508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "address_2": "3RD FLOOR TAUBMAN CENTER RECP B",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095352",
            "telephone_number": "734-936-5582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTER",
        "first_name": "JYOTI",
        "middle_name": "KOTHAVALE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-20",
        "last_updated": "2012-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "11014173A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301100057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.