NPIMap

Individual provider Active NPI

Elango Edhayan, MD

  • Surgery Physician
  • Saint Clair Shores, MI
National Provider Identifier
1770680381
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4301057065 Issued in MI
Practice address
24025 Greater Mack Ave Ste 103
Saint Clair Shores, MI 48080-4311
Phone
(586) 806-3220
Fax
(586) 350-0099
NPI assigned
Sep 19, 2006
Last updated
May 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4301057065 MI Primary

Addresses

Primary practice location

24025 Greater Mack Ave Ste 103
Saint Clair Shores, MI 48080-4311

Mailing address

24025 Greater Mack Ave Ste 103
Saint Clair Shores, MI 48080-4311
Phone (586) 806-3220

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
I20050811000891 MI Practitioner - General Surgery 9830082049 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acute Care Surgeons PCGroup PAC ID 6002956265, 15 clinicians

Practice addresses (Care Compare)

22101 Moross Rd
Detroit, MI 48236-2148
Phone (586) 753-0011

24025 Greater Mack Ave
Suite 103
Saint Clair Shores, MI 48080-4311
Phone (586) 506-3473

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301057065MIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital CurrentSince Aug 31, 2012 Accepting new patients
Pathology Specialists of Southeast Michigan PC Current Accepting new patients
Henry Ford Health St. John Hospital Current Accepting new patients
Kaiser Medical Center PC Surgery CurrentSince Jan 1, 1996 Accepting new patients
Acute Care Surgeons PC CurrentSince Feb 1, 2010 Accepting new patients
Henry Ford Health St. John Hospital Surgery CurrentSince Aug 31, 2012 Accepting new patients
Critical Care Surgeons PLLC Past Accepting new patients

Locations

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

22101 Moross Rd
Ste 270
Detroit, MI 48236
Phone (313) 343-3481

22201 Moross Rd
Ste 150
Grosse Pointe, MI 48236
Phone (313) 343-7110

24025 Greater Mack Ave
Ste 103
St Clr Shores, MI 48080
Phone (586) 506-3473

11670 Martin Rd
Warren, MI 48093
Phone (586) 709-2264

Interoperability endpoints

  • Direct secure messaging: eedhayan1125967@direct.hfhs.org

Organizations & group practices 7

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 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": "1158624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778025600000",
    "number": "1770680381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24025 GREATER MACK AVE STE 103",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480804311",
            "telephone_number": "586-806-3220",
            "fax_number": "586-350-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24025 GREATER MACK AVE STE 103",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480804311",
            "telephone_number": "586-806-3220",
            "fax_number": "586-350-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDHAYAN",
        "first_name": "ELANGO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-19",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301057065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.