Individual provider Active NPI

Anupam Sule, M.D., PH.D.

  • Internal Medicine Physician
  • Pontiac, MI
National Provider Identifier
1699087296
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301096035 Issued in MI
Practice address
44405 Woodward Ave
Pontiac, MI 48341-5023
Phone
(248) 858-6281
Fax
(888) 993-4445
NPI assigned
Jul 12, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Informatics Physician 2083C0008X 4301096035 MI
Internal Medicine Physician 207R00000X 4301096035 MI Primary

Addresses

Primary practice location

44405 Woodward Ave
Pontiac, MI 48341-5023

Mailing address

44405 Woodward Ave
Pontiac, MI 48341-5023
Phone (248) 858-6281

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
I20130905000538 MI Practitioner - Internal Medicine 2961645213 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iha Ooma Primary LLCGroup PAC ID 7012316664, 45 clinicians

Practice addresses (Care Compare)

1375 S Lapeer Rd
Suite 210 Iha Lake Orion Primary Care
Lake Orion, MI 48360-1421
Phone (248) 693-5700

44428 Woodward Ave
102 Trinity Health Henderson Academic Prima
Pontiac, MI 48341-5009
Phone (248) 858-3126

Hospital & facility affiliations

  • Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301096035MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Ooma Primary LLC Internal Medicine CurrentSince Jul 22, 2024 Accepting new patients
Iha Ooma Primary LLC Internal Medicine Current Accepting new patients
Iha Ooma Primary LLC Internal Medicine CurrentSince Jul 22, 2024 Accepting new patients

Locations

1375 S Lapeer Rd
Ste 210
Lake Orion, MI 48360
Phone (248) 693-5700

Interoperability endpoints

  • Direct secure messaging: asule32459@direct.trinity-health.org

Organizations & group practices 3

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 1

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": "1278892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1699087296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44405 WOODWARD AVE",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415023",
            "telephone_number": "248-858-6281",
            "fax_number": "888-993-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44405 WOODWARD AVE",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415023",
            "telephone_number": "248-858-6281",
            "fax_number": "888-993-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULE",
        "first_name": "ANUPAM",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-12",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083C0008X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Clinical Informatics",
            "state": "MI",
            "license": "4301096035",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301096035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.