Individual provider Active NPI

Suraj Suresh, MD

  • Gastroenterology Physician
  • Detroit, MI
National Provider Identifier
1669823902
Registry record updated Apr 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
4301119235 Issued in MI
Practice address
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone
(313) 916-2600
NPI assigned
Jun 28, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 4301109869 MI
Gastroenterology Physician 207RG0100X 4301119235 MI Primary

Addresses

Primary practice location

2799 W Grand Blvd
Detroit, MI 48202-2608

Mailing address

2799 W Grand Blvd
Detroit, MI 48202-2689

Other practice location 1

1500 E Medical Center Dr
TC 3116
Ann Arbor, MI 48109
Phone (810) 227-9510

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
I20200402002241 MI Practitioner - GastroenterologyPractitioner - Internal Medicine 7315230794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Case Western University School of Dental Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy83
Upper gastrointestinal (GI) endoscopy for acid reflux78

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301119235MIMDGastroenterology Physician
4301109869MIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Current Accepting new patients
Henry Ford Health System CurrentSince Mar 1, 2020 Accepting new patients
Henry Ford Health System Gastroenterology CurrentSince Mar 1, 2020 Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients

Locations

1500 E Medical Center Dr
#3116
Ann Arbor, MI 48109
Phone (734) 844-5400

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

2799 W Grand Blvd
#5
Detroit, MI 48202
Phone (313) 916-2710

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

Interoperability endpoints

  • Direct secure messaging: ssuresh564971@direct.hfhs.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586217600000",
    "number": "1669823902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-2600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 E Medical Center Dr",
            "address_2": "TC 3116",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "48109",
            "country_code": "US",
            "telephone_number": "810-227-9510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SURESH",
        "first_name": "SURAJ",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-28",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301109869",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "4301119235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.