Active NPI
Susan Brandel, NP
- Acute Care Nurse Practitioner
- Eastpointe, MI
National Provider Identifier
1629006929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 4704120861
- Practice address
- 22301 Kelly Rd
Eastpointe, MI 48021-2619 - Phone
- (586) 443-5588
- Fax
- (586) 443-5538
- NPI assigned
- Jun 28, 2006
- Last updated
- Jul 21, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 4704120861 | MI | Primary |
Addresses
Primary practice location
22301 Kelly Rd
Eastpointe, MI 48021-2619
Mailing address
22301 Kelly Rd
Eastpointe, MI 48021-2619
Phone (586) 443-5588
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629006929 | Medicaid | MI | |
| 0E012730 | Other | MI | BCBSM GROUP NUMBER |
| 0865316 | Other | MI | BCBS PIN NUMBER |
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)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heritage Medical Group | Past | Accepting new patients | |
| Michigan Home Care Doctors PLLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Practice Physician
- Eastpointe, MI
- NPI 1407803927
-
- Internal Medicine Physician
- Dearborn HTS, MI
- NPI 1730409772
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216598400000",
"number": "1629006929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22301 KELLY RD",
"city": "EASTPOINTE",
"state": "MI",
"postal_code": "480212619",
"telephone_number": "586-443-5588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22301 KELLY RD",
"city": "EASTPOINTE",
"state": "MI",
"postal_code": "480212619",
"telephone_number": "586-443-5588",
"fax_number": "586-443-5538"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRANDEL",
"first_name": "SUSAN",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-28",
"last_updated": "2008-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "MI",
"license": "4704120861",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1629006929",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM GROUP NUMBER",
"identifier": "0E012730",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PIN NUMBER",
"identifier": "0865316",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eastpointe, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.