Active NPI
Sarfaraz A Jasdanwala, MD
- Internal Medicine Physician
- Grand Rapids, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 4301503408
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
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
| License | State | Type | Specialty |
|---|---|---|---|
| 190524 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozark Rural Healthcare LLC | Internal Medicine | Current | Accepting new patients |
| Illinois Rural Healthcare | Internal Medicine | Current | Accepting new patients |
| Saginaw Psychological Services, Inc. | Current | Accepting new patients | |
| Ozark Rural Healthcare LLC | Current | Accepting new patients | |
| Preferred Family Healthcare, Inc | Current | Accepting new patients | |
| Ozark Recovery Housing LLC | Internal Medicine | Current | Accepting new patients |
| FCC Medical Clinics LLC | Current | Accepting new patients | |
| Family Counseling Center, Inc. | Current | Accepting new patients | |
| Preferred Family Healthcare, Inc. | Current | Accepting new patients | |
| Family Counseling Center, Inc. | Current | Accepting new patients | |
| Pacific Medical Partners PC | Internal Medicine | Current | 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.
-
- Community/Behavioral Health Agency
- Kennett, MO
- NPI 1669477550
-
dba FCC Primary Care Clinic
- Rural Health Clinic/Center
- Kennett, MO
- NPI 1043885254
-
- Internal Medicine Physician
- Kansas City, MO
- NPI 1851026439
-
- Internal Medicine Physician
- Detroit, MI
- NPI 1609569169
-
- Internal Medicine Physician
- Detroit, MI
- NPI 1659921278
-
- Psychologist
- Saginaw, MI
- NPI 1821163882
-
- Internal Medicine Physician
- Roseville, CA
- NPI 1770471344
-
- Community/Behavioral Health Agency
- Kirksville, MO
- NPI 1649474206
-
- Internal Medicine Physician
- Wildwood, MO
- NPI 1093493041
-
- Clinic/Center
- Poplar Bluff, MO
- NPI 1871218099
-
dba Corewell Health Medical Group West
- Internal Medicine Physician
- Grand Rapids, MI
- NPI 1235188673
-
dba FCC Primary Care
- Primary Care Clinic/Center
- Poplar Bluff, MO
- NPI 1235738493
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.