Individual provider Active NPI

Sajiv Gugneja, MD, PHD

  • Dermatology Physician
  • Livonia, MI
National Provider Identifier
1508978073
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
4301081272 Issued in MI
Practice address
20234 Farmington Rd
Livonia, MI 48152-1412
Phone
(248) 474-8440
Fax
(248) 474-5714
NPI assigned
Aug 31, 2006
Sex
Male
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
Dermatology Physician 207N00000X 4301081272 MI Primary

Addresses

Primary practice location

20234 Farmington Rd
Livonia, MI 48152-1412

Mailing address

20234 Farmington Rd
Livonia, MI 48152-1412
Phone (248) 474-8440

Other identifiers 1

IdentifierTypeStateIssuer
4811768MedicaidMI

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
I20040427000639 MI Practitioner - Dermatology 0244227866 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Northwestern University Feinberg Medical School, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Consultants in Dermatology, PLLCGroup PAC ID 1557315942, 2 clinicians

Practice addresses (Care Compare)

20234 Farmington Rd
Livonia, MI 48152-1412
Phone (248) 474-8440

Hospital & facility affiliations

  • Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156
  • St Joe Mercy Hospital System Livonia Hospital, Livonia, MI, CCN 230002

Merit-based Incentive Payment System (MIPS)

Final score
45.5 of 100Reported as individual
Quality
55.45
Promoting interoperability
0
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision108
Removal of skin lesions1649
Removal or shaving of skin growth19
Skin biopsy337

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301081272MIMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Consultants in Dermatology, PLLC Dermatology CurrentSince Apr 1, 2005 Accepting new patients

Locations

20234 Farmington Rd
Livonia, MI 48152
Phone (248) 474-8440

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.

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508978073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20234 FARMINGTON RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521412",
            "telephone_number": "248-474-8440",
            "fax_number": "248-474-5714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20234 FARMINGTON RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521412",
            "telephone_number": "248-474-8440",
            "fax_number": "248-474-5714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUGNEJA",
        "first_name": "SAJIV",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301081272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4811768",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.