Individual provider Active NPI

Sanjay Kumar, M.D.

  • Pediatric Gastroenterology Physician
  • Detroit, MI
National Provider Identifier
1457665671
Registry record updated Nov 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
4301096546 Issued in MI
Practice address
22201 Moross Road
Suite 270, Pbii
Detroit, MI 48236
Phone
(313) 343-3481
Fax
(313) 343-7937
NPI assigned
Jul 29, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 4301096546 MI Primary

Addresses

Primary practice location

22201 Moross Road
Suite 270, Pbii
Detroit, MI 48236

Mailing address

22201 Moross Road
Suite 270, Pbii
Detroit, MI 48236
Phone (313) 343-3481

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200122000553 MI Practitioner - Pediatric Medicine 6002057445 Reassigns benefits to 2 organizations
I20210707001729 CA Practitioner - Pediatric Medicine 6002057445 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital CurrentSince Apr 1, 2021 Accepting new patients
Henry Ford Health Macomb-Oakland Hospital CurrentSince Nov 16, 2019 Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Apr 1, 2021 Accepting new patients
Aristamd CurrentSince Apr 1, 2021 Accepting new patients
Henry Ford Health Macomb-Oakland Hospital CurrentSince Nov 16, 2019 Accepting new patients
Henry Ford Health St. John Hospital Current Accepting new patients
St. John Hospital Past Accepting new patients

Locations

4755 Nexus Center Dr
San Diego, CA 92121
Phone (858) 750-4777

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

22201 Moross Rd
Ste 270
Grosse Pointe, MI 48236
Phone (313) 343-3481

17900 23 Mile Rd
Ste 101
Macomb, MI 48044
Phone (586) 868-9010

27483 Dequindre Rd
Ste 204
Madison Hts, MI 48071
Phone (248) 967-7326

1135 W University Dr
Ste 355
Rochester Hills, MI 48307
Phone (248) 680-8060

2800 Livernois Rd
Ste 500
Troy, MI 48083
Phone (586) 753-0400

11800 E 12 Mile Rd
Warren, MI 48093
Phone (586) 573-5000

Interoperability endpoints

  • Direct secure messaging: skumar1135423@direct.hfhs.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1280361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479772800000",
    "number": "1457665671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22201 MOROSS ROAD",
            "address_2": "SUITE 270, PBII",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48236",
            "telephone_number": "313-343-3481",
            "fax_number": "313-343-7937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22201 MOROSS ROAD",
            "address_2": "SUITE 270, PBII",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48236",
            "telephone_number": "313-343-3481",
            "fax_number": "313-343-7937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "SANJAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-29",
        "last_updated": "2016-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "MI",
            "license": "4301096546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.