Individual provider Active NPI

Kushak Suchdev, MD

  • Neurology Physician
  • Columbus, OH
National Provider Identifier
1689806846
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
277246 Issued in MA
Practice address
3555 Olentangy River Rd Ste 2002
Columbus, OH 43214-3910
Phone
(614) 533-5500
Fax
(614) 533-0103
NPI assigned
Aug 20, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 277246 MA Primary
Clinical Neurophysiology Physician 2084N0600X 4301094559 MI
Neurocritical Care Physician 2084A2900X 35.149827 OH
Neurology Physician 2084N0400X 35.149827 OH
Neurology Physician 2084N0400X 4301094559 MI

Addresses

Primary practice location

3555 Olentangy River Rd Ste 2002
Columbus, OH 43214-3910

Mailing address

PO Box 7527
Dublin, OH 43017-0727

Other practice location 1

4201 St Antoine Ste 8A & 8B
University Health Center
Detroit, MI 48201-2153
Phone (313) 745-4275

Other practice location 2

4201 St Antoine Ste 8A & 8B
University Health Center
Detroit, MI 48201-2153
Phone (313) 745-4275

Other practice location 3

725 Albany Street
Shapiro 7, Suite B
Boston, MA 02118
Phone (617) 638-8456

Other practice location 4

680 Centre St
Brockton, MA 02302-3308
Phone (508) 941-7000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ksuchdev1024405@direct.ohiohealth.com OhioHealth Physician Group, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, MA, OH3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20150817002319 MI Practitioner - Neurology 0941515100 Reassigns benefits to 1 organization
I20181127003105 MA Practitioner - Neurology 0941515100 Reassigns benefits to 3 organizations
I20240329002019 OH Practitioner - Neurology 0941515100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians
Signature Healthcare Medical Group IncGroup PAC ID 7719876267, 250 clinicians

Practice addresses (Care Compare)

3535 Olentangy River Rd
Columbus, OH 43214-3908
Phone (614) 566-2934

680 Centre St
Brockton, MA 02302-3308
Phone (508) 941-7000

Hospital & facility affiliations

  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006
  • Grant Medical Center Hospital, Columbus, OH, CCN 360017
  • Signature Healthcare Brockton Hospital Hospital, Brockton, MA, CCN 220052

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.149827OHMDNeurocritical Care Physician
277246MAMDNeurology Physician
4301094559MIMDClinical Neurophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Physicians Organization Inc Neurology CurrentSince Dec 5, 2023 Accepting new patients
Jordan Physician Associates, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Signature Healthcare Medical Group Inc CurrentSince Feb 1, 2025 Accepting new patients
Ohiohealth Corporation CurrentSince Mar 1, 2024 Accepting new patients
Jordan Physician Associates, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Ohiohealth Corporation CurrentSince Mar 1, 2024 Accepting new patients
University Physician Group CurrentSince Sep 1, 2015 Accepting new patients
University Physician Group PastSince Sep 1, 2015 Accepting new patients
Ohiohealth Corporation Past Accepting new patients

Locations

75 Francis St
Boston, MA 02115

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

275 Sandwich St
Plymouth, MA 02360
Phone (508) 746-2000

46 Obery St
Plymouth, MA 02360
Phone (508) 210-5920

4201 Saint Antoine St
Ste 8A
Detroit, MI 48201
Phone (313) 577-8114

4201 Saint Antoine St
Ste 8B
Detroit, MI 48201

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200

1560 E Maple Rd
Ste 400
Troy, MI 48083

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

3555 Olentangy River Rd
Ste 2002
Columbus, OH 43214
Phone (614) 788-2450

3535 Olentangy River Rd
Columbus, OH 43214
Phone (614) 566-1997

Organizations & group practices 9

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 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": "1250726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1689806846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7527",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430170727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 OLENTANGY RIVER RD STE 2002",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143910",
            "telephone_number": "614-533-5500",
            "fax_number": "614-533-0103"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4201 St Antoine Ste 8A & 8B",
            "address_2": "University Health Center",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012153",
            "country_code": "US",
            "telephone_number": "313-745-4275",
            "fax_number": "313-745-4468",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4201 St Antoine Ste 8A & 8B",
            "address_2": "University Health Center",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012153",
            "country_code": "US",
            "telephone_number": "313-745-4275",
            "fax_number": "313-745-4468",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "725 Albany Street",
            "address_2": "Shapiro 7, Suite B",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "02118",
            "country_code": "US",
            "telephone_number": "617-638-8456",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "680 Centre St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023023308",
            "country_code": "US",
            "telephone_number": "508-941-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUCHDEV",
        "first_name": "KUSHAK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-20",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": "277246",
            "primary": true
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "MI",
            "license": "4301094559",
            "primary": false
        },
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "OH",
            "license": "35.149827",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OH",
            "license": "35.149827",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "4301094559",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksuchdev1024405@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group, Inc.",
            "address_1": "3535 Olentangy River Rd",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432143908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.