NPIMap

Organization Active NPI

Southeast Michigan Surgical Hospital, LLC

Doing business as Insight Surgical Hospital

  • General Acute Care Hospital
  • Warren, MI
National Provider Identifier
1962402354
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
500100 Issued in MI
Legal business name
SOUTHEAST MICHIGAN SURGICAL HOSPITAL, LLC
Doing business as
Insight Surgical Hospital
Southeast Michigan Surgical Hospital
Practice address
21230 Dequindre Rd
Warren, MI 48091-2279
Phone
(586) 427-1000
Fax
(586) 759-0237
NPI assigned
Jul 28, 2005
Last updated
May 1, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Authorized official

Name
Mr. Nadir Ijaz
Title
Director
Phone
(810) 275-9371

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X
General Acute Care Hospital 282N00000X 500100 MI Primary

Addresses

Primary practice location

21230 Dequindre Rd
Warren, MI 48091-2279

Mailing address

21230 Dequindre Rd
Warren, MI 48091-2279
Phone (586) 427-1000

Other practice location 1

4800 S Saginaw St
Flint, MI 48507-2677
Phone (810) 275-9333

Other practice location 2

5111 Auto Club Dr
Dearborn, MI 48126-2749
Phone (810) 275-9333

Other identifiers 3

IdentifierTypeStateIssuer
00297OtherMIBCBS PROVIDER ID #
404554179MedicaidMI
00947OtherMICAPE MEDICAL PROV ID#

Other names 2

  • Insight Surgical Hospital Doing business as
  • Southeast Michigan Surgical Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030828000026 MI Part A Provider - Hospital 2860303278 Practice locations: Flint, MI; Warren, MI; Dearborn, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962402354. Details of each certification follow.

Hospital certification: CCN 230264

Legal name
SOUTHEAST MICHIGAN SURGICAL HOSPITAL LLC
Doing business as
INSIGHT SURGICAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Sep 24, 1973
Last certification
Jul 6, 2007
Beds
20
Ownership / control type
Private (not for profit)
Most recent change of ownership
Oct 13, 2003 (2 total)
Organization structure
LLCProprietary
Incorporated
Jun 11, 2003 in MI
Enrollment address
21230 Dequindre Rd
Warren, MI 48091-2279
Main/Primary Hospital Location
Hospital subgroups
Acute care, Short-term

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Southeast Michigan Surgical Hospital LLCCCN 230264 · All quality measures
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Southeast Michigan Surg6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4400 S Saginaw St
Flint, MI 48507
Phone (810) 275-9610

21230 Dequindre Rd
#2
Warren, MI 48091

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Nadir Ijaz Individual Corporate Officer Jan 1, 2019
Operational/Managerial Control Jan 1, 2019
Iinn Holdings Inc Organization, Flint, MI Corporation, For-profit 5% Or Greater Direct Ownership Interest Dec 14, 2018 70%
Jsce Holdings LLC Organization, Flint, MI LLC, For-profit 5% Or Greater Direct Ownership Interest Dec 14, 2018 30%
Jawad Shah Individual 5% Or Greater Indirect Ownership Interest Dec 14, 2018 30%
Corporate OfficerOfficer and Authorized Official Dec 14, 2018
Riazul Huda Individual 5% Or Greater Indirect Ownership Interest Dec 14, 2018 70%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 7

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.

Affiliated clinicians 73

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 73

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746057600000",
    "number": "1962402354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21230 DEQUINDRE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480912279",
            "telephone_number": "586-427-1000",
            "fax_number": "586-759-0237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21230 DEQUINDRE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480912279",
            "telephone_number": "586-427-1000",
            "fax_number": "586-759-0237"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4800 S Saginaw St",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485072677",
            "country_code": "US",
            "telephone_number": "810-275-9333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5111 Auto Club Dr",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481262749",
            "country_code": "US",
            "telephone_number": "810-275-9333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHEAST MICHIGAN SURGICAL HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-28",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A",
        "authorized_official_last_name": "IJAZ",
        "authorized_official_first_name": "NADIR",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "810-275-9371",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MI",
            "license": "500100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID #",
            "identifier": "00297",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "404554179",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPE MEDICAL PROV ID#",
            "identifier": "00947",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Insight Surgical Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southeast Michigan Surgical Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southeast Michigan Surgical Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.