Active NPI
Nikhil Ganesh Puri, M.D
- Student in an Organized Health Care Education/Training Program
- St. Clair Shores, MI
National Provider Identifier
1619801628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 24911 Little Mack
Suite C
St. Clair Shores, MI 48080 - Phone
- (586) 777-2050
- Fax
- (586) 777-2189
- NPI assigned
- Jun 12, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
24911 Little Mack
Suite C
St. Clair Shores, MI 48080
Mailing address
24911 Little Mack
Suite C
St. Clair Shores, MI 48080
Phone (586) 777-2050
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1781222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786060800000",
"number": "1619801628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24911 LITTLE MACK",
"address_2": "SUITE C",
"city": "ST. CLAIR SHORES",
"state": "MI",
"postal_code": "48080",
"telephone_number": "586-777-2050",
"fax_number": "586-777-2189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24911 LITTLE MACK",
"address_2": "SUITE C",
"city": "ST. CLAIR SHORES",
"state": "MI",
"postal_code": "48080",
"telephone_number": "586-777-2050",
"fax_number": "586-777-2189"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PURI",
"first_name": "NIKHIL",
"middle_name": "GANESH",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-06-12",
"last_updated": "2026-08-07",
"certification_date": "2026-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in St. Clair Shores, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.