NPIMap

Individual provider Active NPI

Andrew J Sulich, MD

  • Rheumatology Physician
  • Saint Clair Shores, MI
National Provider Identifier
1508946385
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
AS048976 Issued in MI
Practice address
29200 Harper Ave
Saint Clair Shores, MI 48081-1274
Phone
(586) 777-7577
Fax
(586) 777-6841
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X AS048976 MI Primary

Addresses

Primary practice location

29200 Harper Ave
Saint Clair Shores, MI 48081-1274

Mailing address

29200 Harper Ave
Saint Clair Shores, MI 48081-1274
Phone (586) 777-7577

Other identifiers 2

IdentifierTypeStateIssuer
2594326MedicaidMI
383022841OtherMICOMML INS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address asulich25283@direct.beaumont.edu Health Information Exchange (HIE) Shores Rheumatology PC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101206000390 MI Practitioner - Rheumatology 3375576119 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shores Rheumatology PCGroup PAC ID 3577596311, 6 clinicians

Practice addresses (Care Compare)

29200 Harper Ave
Saint Clair Shores, MI 48081-1274
Phone (586) 777-7577

Hospital & facility affiliations

  • Beaumont Hospital - Grosse Pointe Hospital, Grosse Pointe, MI, CCN 230089
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269
  • Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047
  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130

Merit-based Incentive Payment System (MIPS)

Final score
91.47 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
67.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AS048976MIMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shores Rheumatology PC Rheumatology CurrentSince Feb 24, 1992 Accepting new patients
Henry Ford Health Macomb-Oakland Hospital Past Accepting new patients
Lakeshore Mammography Center PC Past Accepting new patients

Locations

29200 Harper Ave
St Clr Shores, MI 48081
Phone (586) 777-7577

Interoperability endpoints

  • Direct secure messaging: asulich1154859@direct.hfhs.org

Organizations & group practices 3

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 8

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1508946385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29200 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811274",
            "telephone_number": "586-777-7577",
            "fax_number": "586-777-6841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29200 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811274",
            "telephone_number": "586-777-7577",
            "fax_number": "586-777-6841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULICH",
        "first_name": "ANDREW",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MI",
            "license": "AS048976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2594326",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMML INS",
            "identifier": "383022841",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asulich25283@direct.beaumont.edu",
            "affiliation": "Y",
            "affiliationName": "Shores Rheumatology PC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "29200 Harper Ave",
            "city": "Saint Clair Shores",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480811274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.