Spectrum Surgical Specialist PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

4301086474 Issued in MI

Legal business name

SPECTRUM SURGICAL SPECIALIST PC

Practice address

6001 W Outer Dr
Suite 320
Detroit, MI 48235-2614

Phone

(313) 920-5543

NPI assigned

May 2, 2014

Organization subpart

No

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

Authorized official

Name

Manish KhareNPI 1972748366

Title

M.D.

Phone

(313) 920-5543

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Manish Khare, MD

  • Surgery Physician
  • Wayne, MI
  • NPI 1972748366
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1398988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399334400000",
    "number": "1609286384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 TROY DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480835098",
            "telephone_number": "313-920-5543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 W OUTER DR",
            "address_2": "SUITE 320",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482352614",
            "telephone_number": "313-920-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM SURGICAL SPECIALIST PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-02",
        "last_updated": "2014-05-06",
        "status": "A",
        "authorized_official_last_name": "KHARE",
        "authorized_official_first_name": "MANISH",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "313-920-5543"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301086474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "0N30540",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Spears, RD, LD
• Michalene Spears
• Spectra Homecare Health Services LLC
• Spectrum Child and Family Services
• Spectrum Human Services,Inc
• Ashley Sabrina Speed
• Speedy Home Care Services
• Speedy R'S Luxury Transportation, LLC
• Matthew Michael Spehar
• Devan Monique Spence, MD

• Surgery Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.