Individual provider Active NPI

Sujata Surendar Purohit, MD

  • Ophthalmology Physician
  • Ann Arbor, MI
National Provider Identifier
1922069939
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
4301086397 Issued in MI
Practice address
1000 Wall St
Ann Arbor, MI 48105-1912
Phone
(734) 764-4190
NPI assigned
Mar 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 4301086397 MI Primary

Addresses

Primary practice location

1000 Wall St
Ann Arbor, MI 48105-1912

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other practice location 1

1116 W Ganson St
Jackson, MI 49202-4240
Phone (517) 782-9436

Other identifiers 3

IdentifierTypeStateIssuer
4795870MedicaidMI
4795922MedicaidMI
180H149970OtherMIBCBSM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20051103000686 MI Practitioner - Ophthalmology 5597783050 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Michigan Medical School, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of MichiganGroup PAC ID 3779496856, 3,344 clinicians

Practice addresses (Care Compare)

1000 Wall St
Ann Arbor, MI 48105-1912
Phone (734) 764-4190

Hospital & facility affiliations

  • University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301086397MIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid Michigan Eye Care Center, PC Ophthalmology CurrentSince Oct 15, 2005 Accepting new patients
Blue Sky Vision Eye Care, P.C Ophthalmology CurrentSince Jan 1, 2023 Accepting new patients
Regents of the University of Michigan Ophthalmology CurrentSince Jan 14, 2025 Accepting new patients
Blue Sky Vision Eye Care, PC Ophthalmology CurrentSince Jan 1, 2023 Accepting new patients
Regents of the University of Michigan CurrentSince Jan 14, 2025 Accepting new patients
Regents of the University of Michigan Past Accepting new patients
Walker Surgical Center LLC PastSince May 17, 2020 Accepting new patients

Locations

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

1000 Wall St
Ann Arbor, MI 48105
Phone (734) 763-1415

19335 Allen Rd
Brownstown Twp, MI 48183
Phone (734) 479-5580

1600 Commerce Park Dr
Ste 100
Chelsea, MI 48118
Phone (734) 475-7359

1922 Monroe St
Dearborn, MI 48124
Phone (313) 274-7540

750 E Beltline Ave NE
Grand Rapids, MI 49525
Phone (616) 588-6506

4020 E Beltline Ave NE
Grand Rapids, MI 49525
Phone (866) 418-7215

850 W North St
#104
Jackson, MI 49202
Phone (248) 647-9790

1116 W Ganson St
Jackson, MI 49202
Phone (517) 782-9436

Interoperability endpoints

  • Direct secure messaging: spurohit462923@direct.hfhs.org
  • Direct secure messaging: sajatta.purohit.p1@direct.grophthalmology.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 7

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.

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": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1922069939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WALL ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481051912",
            "telephone_number": "734-764-4190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1116 W Ganson St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492024240",
            "country_code": "US",
            "telephone_number": "517-782-9436",
            "fax_number": "517-782-5166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUROHIT",
        "first_name": "SUJATA",
        "middle_name": "SURENDAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301086397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4795870",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4795922",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "180H149970",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.