Individual provider Active NPI

Surianarayanan Karthikeyan, MD

  • Gastroenterology Physician
  • Fargo, ND
National Provider Identifier
1881725836
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
220745-1 Issued in NY
Practice address
321 8TH Ave N
Fargo, ND 58102-4550
Phone
(701) 234-2525
NPI assigned
Mar 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 21916 ND
Gastroenterology Physician 207RG0100X 220745-1 NY Primary

Addresses

Primary practice location

321 8TH Ave N
Fargo, ND 58102-4550

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other practice location 1

80 West Avenue
Suite 203
Brockport, NY 14420-1229
Phone (585) 637-8580

Other practice location 2

50 LeRoy St
Potsdam, NY 13676-1799
Phone (315) 261-4493

Other practice location 3

105 County Route 45A Ste 400
Oswego, NY 13126-6673
Phone (315) 312-0089

Other identifiers 6

IdentifierTypeStateIssuer
02151857MedicaidNY
000526402002OtherNYCOMMUNITY BLUE
P040220745OtherNYBLUE CROSS BLUE SHIELD
0004633179OtherNYAETNA
106259BTOtherNYPREFERRED CARE
P010220745OtherNYBLUE CHOICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040720000024 NY Practitioner - Gastroenterology 3476532771 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Care PCGroup PAC ID 9032367453, 74 clinicians

Practice addresses (Care Compare)

105 County Route 45a
Suite 100
Oswego, NY 13126-6665
Phone (315) 342-6771

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy60
Upper gastrointestinal (GI) endoscopy for acid reflux46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21916NDMDGastroenterology Physician
220745-1NYMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Medical Practice, PC CurrentSince Aug 13, 2019 Accepting new patients
Canton-Potsdam Hospital CurrentSince Nov 16, 2020 Accepting new patients
Rochester General Hospital Current Accepting new patients
Physician Care PC CurrentSince Oct 1, 2021 Accepting new patients
Canton-Potsdam Hospital CurrentSince Nov 16, 2020 Accepting new patients
The Unity Hospital of Rochester CurrentSince Aug 13, 2019 Accepting new patients
The Unity Hospital of Rochester Current Accepting new patients
Rochester General Hospital CurrentSince Aug 13, 2019 Accepting new patients
Gastroenterology Group of Rochester, LLP Gastroenterology Past Accepting new patients

Locations

156 West Ave
Ste 202
Brockport, NY 14420
Phone (585) 637-8580

80 West Ave
Ste 203
Brockport, NY 14420
Phone (585) 637-8580

110 W 6th St
Oswego, NY 13126
Phone (315) 349-5511

105 County Route 45A
Ste 400
Oswego, NY 13126
Phone (315) 312-0089

105 County Route 45A
Ste 100
Oswego, NY 13126
Phone (315) 342-6771

50 Leroy St
Potsdam, NY 13676
Phone (315) 261-6034

201 Market St
Ste E
Potsdam, NY 13676
Phone (315) 274-9102

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

20 Hagen Dr
Ste 330
Rochester, NY 14625
Phone (585) 267-4040

1415 Portland Ave
Ste 570
Rochester, NY 14621
Phone (585) 467-0650

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1881725836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 8TH AVE N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581024550",
            "telephone_number": "701-234-2525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 WEST AVENUE",
            "address_2": "SUITE 203",
            "address_purpose": "LOCATION",
            "city": "Brockport",
            "state": "NY",
            "postal_code": "144201229",
            "country_code": "US",
            "telephone_number": "585-637-8580",
            "fax_number": "585-637-0471",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "50 LeRoy St",
            "address_purpose": "LOCATION",
            "city": "Potsdam",
            "state": "NY",
            "postal_code": "136761799",
            "country_code": "US",
            "telephone_number": "315-261-4493",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 County Route 45A Ste 400",
            "address_purpose": "LOCATION",
            "city": "Oswego",
            "state": "NY",
            "postal_code": "131266673",
            "country_code": "US",
            "telephone_number": "315-312-0089",
            "fax_number": "315-312-0110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KARTHIKEYAN",
        "first_name": "SURIANARAYANAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "ND",
            "license": "21916",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "220745-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02151857",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY BLUE",
            "identifier": "000526402002",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "P040220745",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0004633179",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "106259BT",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "P010220745",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.