Individual provider Active NPI

Sung-Ran Cho, M.D.

  • Psychiatry Physician
  • Southfield, MI
National Provider Identifier
1497796379
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301032129 Issued in MI
Practice address
22170 W 9 Mile Rd
Southfield, MI 48033-6007
Phone
(248) 372-6800
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4301032129 MI Primary

Addresses

Primary practice location

22170 W 9 Mile Rd
Southfield, MI 48033-6007

Mailing address

20905 Greenfield Rd
#305
Southfield, MI 48075-5360
Phone (248) 552-8110

Other identifiers 2

IdentifierTypeStateIssuer
260638180OtherMIBCBS OF MI
1069930MedicaidMI

Other names 1

  • Mrs. Sung-Ran Cho Kim Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pcerecords.essmichigan@direct.mihin.net Easterseals MORC Health Care, Inc.

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
I20101004000900 MI Practitioner - Psychiatry 1254523657 Reassigns benefits to 1 organization
Practice locations: Southfield, MI

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1963
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Easterseals Morc Health Care, IncGroup PAC ID 9830141670, 129 clinicians

Practice addresses (Care Compare)

22170 W 9 Mile Rd
Southfield, MI 48033-6007
Phone (248) 372-6800

29200 Northwestern Hwy 110
Easterseals Morc Southfield
Southfield, MI 48034-1055
Phone (248) 276-8000

6900 E 10 Mile Rd
Easter Seals Macomb County
Center Line, MI 48015-1168
Phone (586) 501-3070

Merit-based Incentive Payment System (MIPS)

Final score
93.79 of 100Reported as group
Quality
90.17
Promoting interoperability
83
Improvement activities
40
Cost
86.64

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301032129MIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Easterseals Morc Health Care, Inc. Psychiatry CurrentSince Nov 3, 2014 Accepting new patients

Locations

2399 E Walton Blvd
Auburn Hills, MI 48326
Phone (248) 475-6400

22170 W 9 Mile Rd
Southfield, MI 48033
Phone (248) 357-8197

Organizations & group practices 1

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1497796379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20905 GREENFIELD RD",
            "address_2": "#305",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480755360",
            "telephone_number": "248-552-8110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22170 W 9 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480336007",
            "telephone_number": "248-372-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHO",
        "first_name": "SUNG-RAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301032129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI",
            "identifier": "260638180",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1069930",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pcerecords.essmichigan@direct.mihin.net",
            "affiliation": "Y",
            "affiliationName": "Easterseals MORC Health Care, Inc.",
            "address_1": "22170 W 9 Mile Rd",
            "city": "Southfield",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480336007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SUNG-RAN",
            "last_name": "KIM",
            "middle_name": "CHO",
            "prefix": "MRS.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.