Individual provider Active NPI

Sarfaraz A Jasdanwala, MD

  • Internal Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1851646665
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301503408 Issued in MI
Practice address
4069 Lake Dr SE Ste 315
Grand Rapids, MI 49546-8816
Phone
(616) 267-7700
NPI assigned
Jul 17, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301503408 MI Primary

Addresses

Primary practice location

4069 Lake Dr SE Ste 315
Grand Rapids, MI 49546-8816

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560

Other practice location 1

4066 Dunnica Ave
Saint Louis, MO 63116-3510
Phone (636) 224-1700

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/
Direct Messaging Address sjasdanwala3611127@epic00.corewelldirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, MI, CA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20150825003318 MO Practitioner - Internal MedicinePractitioner - Family PracticePractitioner - Addiction Medicine 8426364258 Reassigns benefits to 4 organizations
I20210326002179 MI Practitioner - Internal MedicinePractitioner - Addiction Medicine 8426364258 Reassigns benefits to 3 organizations
I20251002001212 CA Practitioner - Internal Medicine 8426364258 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Addiction Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Curana Health of Michigan PLLCGroup PAC ID 9638502917, 39 clinicians
CH MSSP Services Mi PLLCGroup PAC ID 2961862800, 44 clinicians
FCC Medical Clinics LLCGroup PAC ID 1355743741, 3 clinicians
Family Counseling Center IncGroup PAC ID 2163410481, 39 clinicians

Practice addresses (Care Compare)

Detroit, MI 48243
Phone (337) 991-9276

1003 Hauck Dr
Rolla, MO 65401-2584
Phone (312) 953-5636

2102 Orleans St
Detroit, MI 48207-2769
Phone (337) 991-9276

4069 Lake Dr SE
Grand Rapids, MI 49546-8816

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

900 State Route VV
Kennett, MO 63857-3834
Phone (573) 559-2365

925 Hwy VV
Kennett, MO 63857-0071
Phone (573) 888-5925

BLDG 925 Hwy VV
Kennett, MO 63857-0071
Phone (573) 888-5925

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
190524CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ozark Rural Healthcare LLC Internal Medicine CurrentSince Nov 1, 2022 Accepting new patients
Illinois Rural Healthcare Internal Medicine Current Accepting new patients
Saginaw Psychological Services, Inc. CurrentSince Feb 22, 2021 Accepting new patients
Ozark Rural Healthcare LLC Current Accepting new patients
Preferred Family Healthcare, Inc CurrentSince Mar 10, 2019 Accepting new patients
Ozark Recovery Housing LLC Internal Medicine CurrentSince Jan 7, 2025 Accepting new patients
FCC Medical Clinics LLC CurrentSince Jan 1, 2023 Accepting new patients
Family Counseling Center, Inc. CurrentSince May 28, 2018 Accepting new patients
Preferred Family Healthcare, Inc. CurrentSince Mar 10, 2019 Accepting new patients
Family Counseling Center, Inc. CurrentSince May 28, 2018 Accepting new patients
Pacific Medical Partners PC Internal Medicine CurrentSince Jun 17, 2025 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

2999 Douglas Blvd
Ste 180
Roseville, CA 95661
Phone (804) 993-4769

2100 Hemmeter Rd
Saginaw, MI 48603
Phone (989) 799-2100

1 Healthcare Pl
Bowling Green, MO 63334
Phone (573) 324-2111

20 S Sprigg St
Cape Girardeau, MO 63703
Phone (573) 651-4177

500 State Highway J
Hayti, MO 63851
Phone (573) 359-9840

210 Hoover Rd
Jefferson City, MO 65109
Phone (573) 632-4321

8333 E Blue Pkwy
Kansas City, MO 64133
Phone (800) 587-2539

7505 E 87th St
Kansas City, MO 64138
Phone (573) 201-0356

900 State Route VV
Kennett, MO 63857
Phone (573) 559-2365

900 E Laharpe St
Kirksville, MO 63501

3001 Warrior Ln
Poplar Bluff, MO 63901
Phone (573) 785-7453

1003 Hauck Dr
Rolla, MO 65401
Phone (312) 953-5636

4066 Dunnica Ave
Saint Louis, MO 63116
Phone (314) 361-1630

1015 Lanton Rd
West Plains, MO 65775
Phone (417) 256-2570

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1851646665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4069 LAKE DR SE STE 315",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468816",
            "telephone_number": "616-267-7700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4066 Dunnica Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631163510",
            "country_code": "US",
            "telephone_number": "636-224-1700",
            "fax_number": "314-535-5917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JASDANWALA",
        "first_name": "SARFARAZ",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-17",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301503408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "4069 Lake Dr SE Ste 315",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495468816",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjasdanwala3611127@epic00.corewelldirect.org",
            "affiliation": "N",
            "address_1": "4069 Lake Dr SE Ste 315",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495468816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.