Avikshitha Sudhakara, M.D.
Individual provider Active NPI Internal Medicine Physician · Detroit, MI
NPI 1679937189 · NPPES record last updated Feb 5, 2021
Key facts
- NPI
- 1679937189
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 1679937189 (MI)
- Practice address
- 4201 Saint Antoine St
Uhc 9C
Detroit, MI 48201-2153 - Phone
- (313) 745-3000
- NPI assigned
- Apr 11, 2016
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 5
Hospital & facility affiliations 7
Owned or controlled facilities with NPI records 2
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Trenton Total Health Care Center PC
Practice addresses (Care Compare)
1675 Kingsway CT
Trenton, MI 48183-1958
Phone (734) 676-8530
Hospital & facility affiliations
- Residential Home Health
- Corewell Health Trenton Hospital
- Wyandotte Hospital and Medical Center
- Insight Hospital and Medical Center Coldwater
- Aerius Health Center
- Belle Fountain Nursing & Rehabilitation Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Aberdeen Rehablitation & Skilled Nursing Center |
Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Jul 1, 2022 Mar 25, 2025 |
| Aerius Health Center |
Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Jul 1, 2021 Jul 1, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210301000544 | MI | Practitioner - Internal Medicine | 4789976341 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1679937189 | MI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trenton Total Health Care Center PC | Single Specialty | Current |
Accepting new patients |
| Belle Fountain Nursing & Rehabiliation Center Inc | Past | Accepting new patients | |
| Henry Ford Wyandotte Hospital | Single Specialty | Past | Accepting new patients |
| Oakwood Healthcare, Inc. | Past | Accepting new patients | |
| Sana Health Inc | Past |
Accepting new patients |
Locations
1675 Kingsway Ct
Trenton, MI 48183
Phone (734) 676-8530
Interoperability endpoints
- asudhakara717297@direct.hfhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | 1679937189 | MI | Yes |
| Student in an Organized Health Care Education/Training Program | 390200000X | MI |
Addresses
Primary practice location
4201 Saint Antoine St
Uhc 9C
Detroit, MI 48201-2153
Mailing address
4201 Saint Antoine St
Uhc 9C
Detroit, MI 48201-2153
Other providers in Detroit, MI
- John R. Suchomel
- Kristen Suchomel
- Edward S. Suchyta
- Surya Raj Sudarsan
- Chelsea Lapiera Sudderth
- Bhamini Sudhir
- Tiffany Suell
- Jovan Suengas
- Suezette Olaker, MD, PC
- Sufficient Grace Home Health Care Agency LLC
All providers in Detroit, MI · Internal Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.