NPIMap

Individual provider Active NPI

Sameer Surendra Bhagwan, M.D.

  • Internal Medicine Physician
  • Wyandotte, MI
National Provider Identifier
1942680673
Registry record updated Jun 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301107996 Issued in MI
Practice address
995 Ford Ave
Wyandotte, MI 48192
Phone
(734) 284-3100
NPI assigned
Jun 8, 2015
Last updated
Jun 29, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301107996 MI Primary

Addresses

Primary practice location

995 Ford Ave
Wyandotte, MI 48192

Mailing address

995 Ford Ave
Wyandotte, MI 48192-3861
Phone (734) 284-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180613002478 MI Practitioner - Internal Medicine 6305158692 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Beaumont Hospital Medial College - NLG, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sita Medical ClinicGroup PAC ID 6507882826, 3 clinicians

Practice addresses (Care Compare)

995 Ford Ave
Wyandotte, MI 48192-3861
Phone (734) 284-3100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301107996MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sita Medical Clinic Internal Medicine CurrentSince Jul 1, 2018 Accepting new patients
Sciometrix Inc CurrentSince Jan 15, 2023 Accepting new patients
Millennium Medical Group South PC Internal Medicine PastSince Jul 1, 2018 Accepting new patients
Henry Ford Wyandotte Hospital Past Accepting new patients

Locations

306 S Washington Ave
Ste 600
Royal Oak, MI 48067

995 Ford Ave
Wyandotte, MI 48192
Phone (734) 284-3100

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BCJGBD
  • Direct secure messaging: sameer.bhagwan@smc995.eclinicaldirectplus.com
  • Direct secure messaging: sbhagwan@sitamedical.gwaydirect.com
  • Direct secure messaging: sbhagwan528663@direct.hfhs.org

Organizations & group practices 4

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 8

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": "1433721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1942680673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "995 FORD AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481923861",
            "telephone_number": "734-284-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "995 FORD AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "48192",
            "telephone_number": "734-284-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHAGWAN",
        "first_name": "SAMEER",
        "middle_name": "SURENDRA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-08",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301107996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyandotte, MI

Sources for this page

Verify at the official NPI Registry.