NPIMap

Individual provider Active NPI

Surinder Mohan Kaura, MD

  • Internal Medicine Physician
  • Allen Park, MI
National Provider Identifier
1750387056
Registry record updated Dec 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301036001 Issued in MI
Practice address
6801 Allen Rd
Allen Park, MI 48101-2007
Phone
(313) 382-3400
Fax
(313) 382-0150
NPI assigned
Jun 22, 2005
Reactivated
Mar 21, 2006
Last updated
Dec 6, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301036001 MI Primary
Adolescent Medicine (Internal Medicine) Physician 207RA0000X 4301036001 MI

Addresses

Primary practice location

6801 Allen Rd
Allen Park, MI 48101-2007

Mailing address

6801 Allen Rd
Allen Park, MI 48101-2007
Phone (313) 382-3400

Other identifiers 1

IdentifierTypeStateIssuer
4241405-10MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040920000845 MI Practitioner - Internal Medicine 9436127370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6801 Allen Rd
Allen Park, MI 48101-2007
Phone (313) 382-3400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301036001MIMDAdolescent Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CVM of Michigan PLLC CurrentSince Feb 1, 2020 Accepting new patients
S.M. Kaura M.D., PLLC Internal Medicine CurrentSince Oct 1, 1998 Accepting new patients
Satinder Kumar Aggarwal MD P C Internal Medicine Past Accepting new patients
Millennium Medical Group South PC Internal Medicine Past Accepting new patients

Locations

6801 Allen Rd
Allen Park, MI 48101
Phone (313) 382-3400

3912 Fort St
Lincoln Park, MI 48146
Phone (313) 382-3400

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DIGCCA/Endpoint/DIGCCA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575590400000",
    "number": "1750387056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 ALLEN RD",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481012007",
            "telephone_number": "313-382-3400",
            "fax_number": "313-382-0150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 ALLEN RD",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481012007",
            "telephone_number": "313-382-3400",
            "fax_number": "313-382-0150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAURA",
        "first_name": "SURINDER",
        "middle_name": "MOHAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2019-12-06",
        "deactivation_date": "2006-03-15",
        "reactivation_date": "2006-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301036001",
            "primary": true
        },
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "MI",
            "license": "4301036001",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4241405-10",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen Park, MI

Sources for this page

Verify at the official NPI Registry.