Individual provider Active NPI

Samah Halbouni Suede, MD

  • Nephrology Physician
  • Roseville, MI
National Provider Identifier
1336763937
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
4301515015 Issued in MI
Practice address
18001 E 10 Mile Rd
Roseville, MI 48066-3803
Phone
(586) 218-5800
Fax
(586) 218-5808
NPI assigned
May 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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 4351046716 MI
Nephrology Physician 207RN0300X 4301515015 MI Primary

Addresses

Primary practice location

18001 E 10 Mile Rd
Roseville, MI 48066-3803

Mailing address

18001 E 10 Mile Rd
Roseville, MI 48066-3803
Phone (586) 218-5800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250711000376 MI Practitioner - Nephrology 9335531540 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Clair Specialty Physicians PCGroup PAC ID 6204733256, 36 clinicians

Practice addresses (Care Compare)

18001 E 10 Mile Rd
Roseville, MI 48066-3983
Phone (586) 218-5800

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Clair Specialty Physicians PC Nephrology CurrentSince Jul 3, 2025 Accepting new patients
Colorado Springs Nephrology Nephrology Past Accepting new patients

Locations

18001 E 10 Mile Rd
Ste 1
Roseville, MI 48066
Phone (586) 218-5800

18001 E 10 Mile Rd
Roseville, MI 48066

23857 Greenfield Rd
Southfield, MI 48075
Phone (248) 569-6111

45650 Schoenherr Rd
Utica, MI 48315
Phone (586) 286-7800

45640 Schoenherr Rd
Ste B
Utica, MI 48315
Phone (586) 247-4300

Organizations & group practices 2

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 9

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": "1590883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1336763937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18001 E 10 MILE RD",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480663803",
            "telephone_number": "586-218-5800",
            "fax_number": "586-218-5808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18001 E 10 MILE RD",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480663803",
            "telephone_number": "586-218-5800",
            "fax_number": "586-218-5808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUEDE",
        "first_name": "SAMAH",
        "middle_name": "HALBOUNI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-31",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4351046716",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "4301515015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MI

Sources for this page

Verify at the official NPI Registry.