Individual provider Active NPI

Suneel Kumar Pigilam

  • Physician Assistant
  • Kalamazoo, MI
National Provider Identifier
1760014500
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601010265 Issued in MI
Practice address
1722 Shaffer St
Kalamazoo, MI 49048-1633
Phone
(269) 381-3963
NPI assigned
Feb 10, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 5601010265 MI Primary

Addresses

Primary practice location

1722 Shaffer St
Kalamazoo, MI 49048-1633

Mailing address

1722 Shaffer St
Kalamazoo, MI 49048-1633

Other practice location 1

1280 E Campus Dr
Mount Pleasant, MI 48858-3803
Phone (517) 488-3239

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210208002568 MI Practitioner - Physician Assistant 4486069283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Central Michigan College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ascension Medical Group PromedGroup PAC ID 7315856077, 255 clinicians

Practice addresses (Care Compare)

1521 Gull Rd
Kalamazoo, MI 49048-1640
Phone (269) 226-5165

215 E Mansion St
1H Borgess Neurology
Marshall, MI 49068-1167
Phone (269) 789-8120

7901 Angling Rd
Portage, MI 49024-0714

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601010265MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Promed Healthcare CurrentSince Feb 28, 2021 Accepting new patients
Ascension Medical Group Promed Cardiovascular Disease Past Accepting new patients

Locations

555 Linn St
Allegan, MI 49010
Phone (269) 673-8424

3035 Capital Ave SW
Battle Creek, MI 49015
Phone (269) 565-9100

30 S Howell St
Hillsdale, MI 49242
Phone (517) 437-2490

1717 Shaffer St
Ste 002
Kalamazoo, MI 49048

1722 Shaffer St
Ste 1
Kalamazoo, MI 49048
Phone (269) 381-3963

3025 Gull Rd
Kalamazoo, MI 49048
Phone (269) 343-1264

1722 Shaffer St
Kalamazoo, MI 49048
Phone (269) 226-5600

1521 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5165

215 E Mansion St
Marshall, MI 49068
Phone (269) 789-3940

671 Allegan St
Ste B
Plainwell, MI 49080
Phone (269) 685-3123

671 Allegan St
Plainwell, MI 49080
Phone (269) 685-1002

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

600 S Lakeview Ave
Ste 105
Sturgis, MI 49091
Phone (269) 651-9470

711 S Health Parkway
Ste 1
Three Rivers, MI 49093
Phone (269) 273-8557

711 S Health Parkway
Three Rivers, MI 49093
Phone (269) 273-9691

Organizations & group practices 2

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 2

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": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1760014500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 SHAFFER ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 SHAFFER ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481633",
            "telephone_number": "269-381-3963"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1280 E Campus Dr",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "MI",
            "postal_code": "488583803",
            "country_code": "US",
            "telephone_number": "517-488-3239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIGILAM",
        "first_name": "SUNEEL",
        "middle_name": "KUMAR",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-10",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.