Suha Kassab DPM PC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

SK001415 Issued in MI

Legal business name

SUHA KASSAB DPM PC

Practice address

10 W Square Lake Rd
Ste300
Bloomfield Hills, MI 48302-0465

Phone

(248) 333-4900

Fax

(248) 333-4905

NPI assigned

Mar 26, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Suha Kassab, DPMNPI 1902890015

Title

President

Phone

(248) 333-4900

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI2 enrollments

Enrollment records 2

Tax ID family

Suha Kassab DPM PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Suha Kassab DPM PC

  • Podiatrist
  • Bloomfield Hills, MI
  • NPI 1316767403
  NPD tax ID

Locations

Practitioners 1

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

• Suha F Kassab, DPM

  • Podiatrist
  • Bloomfield Hills, MI
  • NPI 1902890015
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729641600000",
    "number": "1619149010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 W SQUARE LAKE RD",
            "address_2": "STE 300",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020465",
            "telephone_number": "248-333-4900",
            "fax_number": "248-333-4905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 W SQUARE LAKE RD",
            "address_2": "STE300",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020465",
            "telephone_number": "248-333-4900",
            "fax_number": "248-333-4905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUHA KASSAB DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-26",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A",
        "authorized_official_last_name": "KASSAB",
        "authorized_official_first_name": "SUHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-333-4900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "SK001415",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC LINCENSE",
            "identifier": "SK001415",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2592751",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gerald Mark Stulberg, D.D.S.
• Julie Stulberg, BA, RYT
• Sue a Reid Parisi DDS PC
• Sue Shoha DDS PLLC
• Suha Kassab DPM PC
• Doraikannu Sukumaran, M.D.
• Daniel Sumbal, DDS
• Suresha Bandara MDPC
• Eric Suris, D.O.
• Susan I Leitman, PHD, PC

• Podiatrist in Bloomfield Hills, MI
• Providers in Bloomfield Hills, MI by specialty
• Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.