Organization Active NPI

Neurology & Pain Institute PLLC

  • Ambulatory Surgical Clinic/Center
  • Port Huron, MI
National Provider Identifier
1811300155
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
NEUROLOGY & PAIN INSTITUTE PLLC
Practice address
1103 7TH St Ste C
Port Huron, MI 48060-5497
Phone
(810) 990-6880
Fax
(810) 990-6881
NPI assigned
Jun 4, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Authorized official

Name
Dr. Marwan Shuayto, MDNPI 1841383924
Title
Authorized Official
Phone
(810) 989-6880

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

1103 7TH St Ste C
Port Huron, MI 48060-5497

Mailing address

1103 7TH St Ste C
Port Huron, MI 48060
Phone (810) 990-6880

Other names 1

  • Port Huron Surgical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231019000686 MI Part B Supplier - Ambulatory Surgical Center 0244452266 Receives reassigned benefits from 6 practitioners
Practice locations: Port Huron, MI

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Neurology and Pain Institute PLLC Dba Port Huron Surgical CenterCCN 23C0001159
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2283888Port Huron Surgical Center1103 7TH Street Suite C, Port Huron, MI 48060Certificate of waiverJun 13, 2027

National Provider Directory

National Provider Directory

Locations

1103 7th St
Ste B
Port Huron, MI 48060

1103 7th St
Ste C
Port Huron, MI 48060
Phone (810) 990-6880

1103 7th St
Port Huron, MI 48060

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1401840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695859200000",
    "number": "1811300155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 7TH ST STE C",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "48060",
            "telephone_number": "810-990-6880",
            "fax_number": "810-990-6881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 7TH ST STE C",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480605497",
            "telephone_number": "810-990-6880",
            "fax_number": "810-990-6881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGY & PAIN INSTITUTE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-04",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A",
        "authorized_official_last_name": "SHUAYTO",
        "authorized_official_first_name": "MARWAN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "810-989-6880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Port Huron Surgical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Huron, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.