Individual provider Active NPI

Mini Sunilkumar, M.D.

  • Family Medicine Physician
  • Chesterfield, MI
National Provider Identifier
1477502292
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301078753 Issued in MI
Practice address
32743 23 Mile Rd
Chesterfield, MI 48047-1985
Phone
(586) 725-9600
Fax
(586) 725-7170
NPI assigned
May 9, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301078753 MI Primary

Addresses

Primary practice location

32743 23 Mile Rd
Chesterfield, MI 48047-1985

Mailing address

401 S. Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

Other identifiers 4

IdentifierTypeStateIssuer
4657882MedicaidMI
4657891MedicaidMI
4659161MedicaidMI
4963394MedicaidMI

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
I20041111000497 MI Practitioner - Family Practice 3678536489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Downriver Community Services IncGroup PAC ID 9335135409, 12 clinicians

Practice addresses (Care Compare)

1011 Military St
Port Huron, MI 48060-5416
Phone (810) 488-8000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Downriver Community Services, Inc. Family Medicine CurrentSince Oct 6, 2014 Accepting new patients
Downriver Community Services, Inc. CurrentSince Oct 6, 2014 Accepting new patients
Downriver Community Services, Inc. Current Accepting new patients
McLaren Medical Group PastSince Apr 1, 2012 Accepting new patients
McLaren Flint Past Accepting new patients

Locations

555 Saint Clair River Dr
Algonac, MI 48001
Phone (810) 794-4917

1011 Military St
Port Huron, MI 48060
Phone (810) 488-8000

Interoperability endpoints

  • Direct secure messaging: mini.sunilkumar@dcsi.eclinicaldirectplus.com

Organizations & group practices 5

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

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477502292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S. BALLENGER HWY",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "48532",
            "telephone_number": "810-342-1000",
            "fax_number": "810-342-1591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32743 23 MILE RD",
            "city": "CHESTERFIELD",
            "state": "MI",
            "postal_code": "480471985",
            "telephone_number": "586-725-9600",
            "fax_number": "586-725-7170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNILKUMAR",
        "first_name": "MINI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301078753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4657882",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4657891",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4659161",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4963394",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MI

Sources for this page

Verify at the official NPI Registry.