Individual provider Active NPI

Sandeep Khurana, M.D.

  • Cardiovascular Disease Physician
  • Grandville, MI
National Provider Identifier
1720063787
Registry record updated Sep 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
4301053818 Issued in MI
Practice address
3181 Prairie St SW
Suite 112
Grandville, MI 49418-2097
Phone
(616) 780-7015
Fax
(866) 966-9677
NPI assigned
Dec 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 4301053818 MI Primary
Interventional Cardiology Physician 207RI0011X 4301053818 MI

Addresses

Primary practice location

3181 Prairie St SW
Suite 112
Grandville, MI 49418-2097

Mailing address

3181 Prairie St SW
Suite 112
Grandville, MI 49418-2097
Phone (616) 780-7015

Other identifiers 2

IdentifierTypeStateIssuer
0603410481OtherMIBCBS
1720063787MedicaidMI

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
I20050503001201 MI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Preventive Medicine 9638119274 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Preventive Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4081 Cascade Rd SE
Suite 200
Grand Rapids, MI 49546-2170
Phone (616) 780-7015

Hospital & facility affiliations

  • Corewell Health Zeeland Hospital Hospital, Zeeland, MI, CCN 230003
  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301053818MIMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Heart Cardiology, PLC Cardiovascular Disease CurrentSince Sep 6, 2007 Accepting new patients
West Michigan Cardiology, PC PastSince May 28, 2023 Accepting new patients
Cardiovascular Institute of the South, LLC Cardiovascular Disease Past Accepting new patients
West Michigan Cardiology, PC Past Accepting new patients

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 3

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": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348099200000",
    "number": "1720063787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 PRAIRIE ST SW",
            "address_2": "SUITE 112",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182097",
            "telephone_number": "616-780-7015",
            "fax_number": "866-966-9677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 PRAIRIE ST SW",
            "address_2": "SUITE 112",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182097",
            "telephone_number": "616-780-7015",
            "fax_number": "866-966-9677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHURANA",
        "first_name": "SANDEEP",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2012-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301053818",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MI",
            "license": "4301053818",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0603410481",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720063787",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grandville, MI

Sources for this page

Verify at the official NPI Registry.