Individual provider Active NPI

Saeed Basheer Sufyan, PA

  • Medical Physician Assistant
  • Lansing, MI
National Provider Identifier
1780314435
Registry record updated Oct 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
1601 E Kalamazoo St
Lansing, MI 48912-2701
Phone
(517) 862-2915
NPI assigned
Jun 15, 2022
Last updated
Oct 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X NU Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

1601 E Kalamazoo St
Lansing, MI 48912-2701

Mailing address

2191 Meadowlawn Dr Apt B
Holt, MI 48842-1242
Phone (517) 410-1254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230103000522 MI Practitioner - Physician Assistant 0749650042 Reassigns benefits to 1 organization
I20240809000799 FL Practitioner - Physician Assistant 0749650042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jacksonville Carenow Urgent Care LLCGroup PAC ID 6800158544, 44 clinicians

Practice addresses (Care Compare)

9925 San Jose Blvd
Suite 1
Jacksonville, FL 32257-5899
Phone (904) 328-5504

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Avecina Medical PA CurrentSince Aug 1, 2024 Accepting new patients
Jacksonville Carenow Urgent Care, LLC CurrentSince Mar 15, 2026 Accepting new patients
Avecina Medical, PA CurrentSince Aug 1, 2024 Accepting new patients
Specialty Investments PastSince Apr 3, 2017 Accepting new patients
Avecina Medical PA Past Accepting new patients
Lansing Urgent Care, PLC Past Accepting new patients

Locations

4815 Sweetgrass Pl
Unit 201
Jacksonville, FL 32224
Phone (904) 367-3372

9580 Applecross Rd
Ste 106
Jacksonville, FL 32222
Phone (904) 778-9180

9925 San Jose Blvd
Ste 1
Jacksonville, FL 32257
Phone (904) 328-5504

1633 Race Track Rd
Ste 101
St Johns, FL 32259
Phone (904) 230-6988

Interoperability endpoints

  • Direct secure messaging: saeed.sufyan.p1@direct.ichd.nextgenshare.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1655251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1780314435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2191 MEADOWLAWN DR APT B",
            "city": "HOLT",
            "state": "MI",
            "postal_code": "488421242",
            "telephone_number": "517-410-1254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E KALAMAZOO ST",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489122701",
            "telephone_number": "517-862-2915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUFYAN",
        "first_name": "SAEED",
        "middle_name": "BASHEER",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-15",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.