Plastic Surgery Center Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PLASTIC SURGERY CENTER INC

Practice address

16100 19 Mile Rd
Suite 100
Clinton Township, MI 48038-1148

Phone

(586) 263-9657

Fax

(586) 263-0436

NPI assigned

Nov 11, 2005

Organization subpart

No

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

Authorized official

Name

Sudarshan R Reddy, MD FACSNPI 1073597217

Title

Sole Owner of Facility

Phone

(586) 263-6050

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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

• Sudarshan R Reddy, M.D.

  • Plastic Surgery Physician
  • Clinton TWP, MI
  • NPI 1073597217
  NPD (past) Authorized official

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902887300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16100 19 MILE RD",
            "address_2": "SUITE 100",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381148",
            "telephone_number": "586-263-9657",
            "fax_number": "586-263-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16100 19 MILE RD",
            "address_2": "SUITE 100",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381148",
            "telephone_number": "586-263-9657",
            "fax_number": "586-263-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC SURGERY CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "SUDARSHAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "SOLE OWNER OF FACILITY",
        "authorized_official_telephone_number": "586-263-6050",
        "authorized_official_credential": "MD FACS"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "E01483",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "Z40007538",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John George Pisan, MD
• Rebecca Ann Loechli Pisan, MD
• Brian Pitko
• Brian Joseph Pizzimenti, BSW,LBSW
• Place of Healing Physical Therapy LLC
• Alexander Goodharbor Platt-Koch, DO
• Renee Marie Plegue, MOT,OTR
• Robert Thomas Plunkett, DDS,MS
• Laurie Ann Pocius
• Erica Rae Podsiadly, BA

• Ambulatory Surgical Clinic/Center in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Ambulatory Surgical Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.