Individual provider Active NPI

Dennis G Suzara, DO

  • Physical Medicine & Rehabilitation Physician
  • Grand Rapids, MI
National Provider Identifier
1407162217
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
5101021449 Issued in MI
Practice address
221 Michigan St NE Ste 400
Grand Rapids, MI 49503-2543
Phone
(616) 486-9600
Fax
(616) 774-5454
NPI assigned
Aug 31, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 5101021449 MI Primary

Addresses

Primary practice location

221 Michigan St NE Ste 400
Grand Rapids, MI 49503-2543

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dsuzara106412@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/

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
I20140924001637 MI Practitioner - Physical Medicine and Rehabilitation 5597984518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Lake Erie College of Osteopathic Medicine, Erie, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Physical Rehabilitation IncGroup PAC ID 6901717768, 352 clinicians
Center for Physical Rehabilitation and Therapy LPGroup PAC ID 0941513303, 365 clinicians

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115

1009 W Green St
Corewell Health Medical Group West
Hastings, MI 49058-1710
Phone (269) 945-1212

1840 Wealthy St SE
Corewell Health Medical Group West
Grand Rapids, MI 49506-2921
Phone (616) 885-5000

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

5060 Cascade Rd
Grand Rapids, MI 49546-3808

5060 Cascade Rd SE
Grand Rapids, MI 49546-3808

605 Oak St
Big Rapids, MI 49307-2048
Phone (231) 592-4270

Hospital & facility affiliations

  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101021449MIMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Oct 24, 2014 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Oct 24, 2014 Accepting new patients
Spectrum Health Primary Care Partners Current Accepting new patients

Locations

1840 Wealthy St SE
Grand Rapids, MI 49506
Phone (616) 391-1730

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

750 Fuller Ave NE
Grand Rapids, MI 49503
Phone (616) 336-4846

221 Michigan St NE
Ste 400
Grand Rapids, MI 49503
Phone (616) 486-9600

426 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 267-7888

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

Interoperability endpoints

  • Direct secure messaging: dsuzara106412@epic00.shdirect.org
  • Direct secure messaging: dsuzara106412@epic00.corewelldirect.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 2

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": "1283212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1407162217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 MICHIGAN ST NE STE 400",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032543",
            "telephone_number": "616-486-9600",
            "fax_number": "616-774-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUZARA",
        "first_name": "DENNIS",
        "middle_name": "G",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-31",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "5101021449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dsuzara106412@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "221 Michigan St NE Ste 400",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032543",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "221 Michigan St NE Ste 400",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.