NPIMap

Organization Active NPI

Southfield Radiology Associates PLLC

  • Diagnostic Radiology Physician
  • Southfield, MI
National Provider Identifier
1871525915
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
SOUTHFIELD RADIOLOGY ASSOCIATES PLLC
Practice address
23100 Providence Dr
Suite 420
Southfield, MI 48075-3646
Phone
(248) 569-4353
Fax
(248) 569-5227
NPI assigned
Jul 7, 2006
Last updated
Dec 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Authorized official

Name
Dr. Edsa Negussie, MDNPI 1821021486
Title
President
Phone
(248) 308-2745

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
Diagnostic Radiology Physician 2085R0202X Primary

Addresses

Primary practice location

23100 Providence Dr
Suite 420
Southfield, MI 48075-3646

Mailing address

16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone (248) 569-4353

Other identifiers 2

IdentifierTypeStateIssuer
0F36131OtherMIBLUE CROSS BLUE SHIELD
A3477OtherMIRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040528000549 MI Part B Supplier - Clinic/Group Practice 6800877481 Receives reassigned benefits from 51 practitioners
1 other NPI on this enrollment
Practice locations: Rochester Hills, MI; Southfield, MI; Oxford, MI; Oak Park, MI; Novi, MI; Milford, MI; Marquette, MI; Lathrup Village, MI…
O20260505001347 TX Part B Supplier - Clinic/Group Practice 6800877481 Receives reassigned benefits from 1 practitioner
Practice locations: McKinney, TX

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

37595 7 Mile Rd
Livonia, MI 48152
Phone (734) 462-2300

1050 Corporate Office Dr
Milford, MI 48381
Phone (248) 684-6155

355 Barclay Cir
Ste B
Rochester Hills, MI 48307
Phone (248) 601-6161

22250 Providence Dr
Ste 207
Southfield, MI 48075
Phone (248) 552-0360

Practitioners & affiliated clinicians

Practitioners 74

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 74

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764806400000",
    "number": "1871525915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16001 W 9 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754818",
            "telephone_number": "248-569-4353",
            "fax_number": "248-569-5227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23100 PROVIDENCE DR",
            "address_2": "SUITE 420",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753646",
            "telephone_number": "248-569-4353",
            "fax_number": "248-569-5227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHFIELD RADIOLOGY ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A",
        "authorized_official_last_name": "NEGUSSIE",
        "authorized_official_first_name": "EDSA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-308-2745",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0F36131",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "A3477",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.