Individual provider Active NPI

Surya Rao Thota, M.D.

  • Anesthesiology Physician
  • Flint, MI
National Provider Identifier
1790739068
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4301041520 Issued in MI
Practice address
1 Hurley PLZ
Flint, MI 48503-5902
Phone
(810) 257-9284
NPI assigned
May 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 4301041520 MI Primary

Addresses

Primary practice location

1 Hurley PLZ
Flint, MI 48503-5902

Mailing address

1 Hurley PLZ
Flint, MI 48503-5902
Phone (810) 257-9284

Other identifiers 1

IdentifierTypeStateIssuer
5705237OtherMIAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040218001005 MI Practitioner - Anesthesiology 3577458504 Reassigns benefits to 2 organizations
I20240613002755 IL Practitioner - Anesthesiology 3577458504 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2 Good Samaritan Way
Suite 200
Mount Vernon, IL 62864-2476
Phone (618) 899-3869

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301041520MIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genesee Medical Anesthesia, PC Anesthesiology CurrentSince Feb 1, 1997 Accepting new patients
Anesthesia Associates of Southern Illinois Surgery Center LLC Anesthesiology CurrentSince Jun 2, 2025 Accepting new patients
Memorial Hospital Anesthesiology CurrentSince Oct 4, 2022 Accepting new patients
Memorial Hospital CurrentSince May 1, 2025 Accepting new patients
Northstar Anesthesia of Illinois, LLC Anesthesiology CurrentSince May 4, 2024 Accepting new patients
Memorial Hospital CurrentSince May 1, 2025 Accepting new patients
Memorial Hospital Anesthesiology CurrentSince Oct 4, 2022 Accepting new patients
Monroe Community Health Services Past Accepting new patients
West Central Anesthesiology Group LTD Anesthesiology Past Accepting new patients

Locations

13500 Powers Ct
Ste 230
Fort Myers, FL 33912
Phone (239) 610-0784

1900 State St
Chester, IL 62233
Phone (618) 826-2388

2 Good Samaritan Way
Ste 200
Mount Vernon, IL 62864
Phone (618) 899-3869

4225 Lincolnshire Dr
Ste B
Mount Vernon, IL 62864

1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160

1 Hurley Plz
Flint, MI 48503
Phone (810) 257-9000

5202 Miller Rd
Flint, MI 48507
Phone (810) 720-8900

826 W King St
Owosso, MI 48867
Phone (989) 720-2273

3337 Britton Rd
Perry, MI 48872
Phone (517) 625-3004

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790739068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HURLEY PLZ",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485035902",
            "telephone_number": "810-257-9284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HURLEY PLZ",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485035902",
            "telephone_number": "810-257-9284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOTA",
        "first_name": "SURYA",
        "middle_name": "RAO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301041520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5705237",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.