Individual provider Active NPI

Syed Irfan-Ur Rahman

  • Gastroenterology Physician
  • Monroe, MI
National Provider Identifier
1619396942
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
4301501725 Issued in MI
Practice address
1066 N Monroe St
Monroe, MI 48162-3113
Phone
(734) 240-4870
Fax
(734) 682-5083
NPI assigned
Apr 15, 2014
Last updated
Oct 21, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301501725 MI
Gastroenterology Physician 207RG0100X 4301501725 MI Primary

Addresses

Primary practice location

1066 N Monroe St
Monroe, MI 48162-3113

Mailing address

100 Madison Ave
Toledo, OH 43604-1516

Other practice location 1

8701 W Watertown Plank Rd
Milwaukee, WI 53226-3548
Phone (414) 955-8296

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address srahman194221@epicdirect.promedica.org

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
I20200730003063 MI Practitioner - Gastroenterology 2365720745 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
St. Louis College of Physicians and Surgeons, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Promedica Monroe PhysiciansGroup PAC ID 2365696176, 64 clinicians

Practice addresses (Care Compare)

1066 N Monroe St
Monroe Gastroenterology
Monroe, MI 48162-3113
Phone (734) 430-3152

3175 Smith Rd
Lambertville, MI 48144-9434
Phone (734) 856-5494

718 N Macomb St
Monroe, MI 48162-7815
Phone (734) 240-8987

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy62
Upper gastrointestinal (GI) endoscopy for acid reflux73

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301501725MIMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Monroe Physicians Internal Medicine CurrentSince Aug 1, 2020 Accepting new patients
McLaren Northern Michigan CurrentSince Dec 31, 2023 Accepting new patients
McLaren Northern Michigan CurrentSince Dec 31, 2023 Accepting new patients

Locations

3175 Smith Rd
Lambertville, MI 48144
Phone (734) 856-5494

1066 N Monroe St
Monroe, MI 48162
Phone (734) 240-4870

14930 Laplaisance Rd
Ste 118
Monroe, MI 48161
Phone (734) 240-2892

2390 Mitchell Park Dr
Ste D
Petoskey, MI 49770
Phone (231) 242-1760

416 Connable Ave
Petoskey, MI 49770
Phone (231) 487-4000

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

333 N Summit St
Fl 7
Toledo, OH 43604
Phone (419) 252-5909

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1619396942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MADISON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1066 N MONROE ST",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481623113",
            "telephone_number": "734-240-4870",
            "fax_number": "734-682-5083"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8701 W Watertown Plank Rd",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263548",
            "country_code": "US",
            "telephone_number": "414-955-8296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAHMAN",
        "first_name": "SYED",
        "middle_name": "IRFAN-UR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-15",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301501725",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "4301501725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "srahman194221@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monroe, MI

Sources for this page

Verify at the official NPI Registry.