Individual provider Active NPI

Reema Sutariya, PA-C

  • Physician Assistant
  • Southfield, MI
National Provider Identifier
1760853147
Registry record updated Apr 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007442 Issued in MI
Practice address
24901 Northwestern Hwy Ste 214
Southfield, MI 48075-2205
Phone
(248) 483-8488
NPI assigned
Oct 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601007442 MI Primary

Addresses

Primary practice location

24901 Northwestern Hwy Ste 214
Southfield, MI 48075-2205

Mailing address

24901 Northwestern Hwy Ste 214
Southfield, MI 48075-2205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601007442MIMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1444608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459900800000",
    "number": "1760853147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24901 NORTHWESTERN HWY STE 214",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24901 NORTHWESTERN HWY STE 214",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752205",
            "telephone_number": "248-483-8488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTARIYA",
        "first_name": "REEMA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-12",
        "last_updated": "2016-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.