Individual provider Active NPI

Sante D Bologna, MD

  • Gastroenterology Physician
  • Troy, MI
National Provider Identifier
1972585925
Registry record updated Feb 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
4301406457 Issued in MI
Practice address
4600 Investment Dr
Ste 380
Troy, MI 48098-6365
Phone
(248) 267-5025
Fax
(248) 267-5026
NPI assigned
Nov 16, 2005
Last updated
Feb 12, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 4301406457 MI Primary

Addresses

Primary practice location

4600 Investment Dr
Ste 380
Troy, MI 48098-6365

Mailing address

4600 Investment Dr
Ste 380
Troy, MI 48098-6365
Phone (248) 844-9710

Other identifiers 1

IdentifierTypeStateIssuer
2839447MedicaidMI

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
I20041222000241 MI Practitioner - Gastroenterology 5698766764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Wayne State University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Troy Gastroenterology PCGroup PAC ID 9739143991, 47 clinicians

Practice addresses (Care Compare)

1701 S Blvd E
Suite 300
Rochester Hills, MI 48307-6120
Phone (248) 844-9710

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-5000

48001 Romeo Plank Rd
Suite 105
Macomb, MI 48044-2165
Phone (248) 844-9710

48801 Romeo Plank Rd
Suite 101
Macomb, MI 48044-2165
Phone (586) 726-8436

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy260
Upper gastrointestinal (GI) endoscopy for acid reflux197

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301406457MIMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Troy Gastroenterology PC Gastroenterology CurrentSince Dec 1, 1994 Accepting new patients
Troy Gastroenterology, PC Gastroenterology CurrentSince Dec 1, 1994 Accepting new patients
Troy Gastroenterology, PC Current Accepting new patients
Pinnacle Anesthesia PLLC Past Accepting new patients
Prime Healthcare Services-Port Huron LLC Past Accepting new patients
Lapeer County Surgery Center LLC Past Accepting new patients
Macomb Endoscopy Center, PLC PastSince Feb 9, 2011 Accepting new patients

Locations

1546 Callis Rd
Lapeer, MI 48446
Phone (810) 667-4000

48801 Romeo Plank Rd
Ste 101
Macomb, MI 48044
Phone (586) 726-8423

48801 Romeo Plank Rd
Ste 105
Macomb, MI 48044
Phone (586) 226-2722

2601 Electric Ave
Port Huron, MI 48060
Phone (810) 216-1500

1701 South Blvd E
Ste 300
Rochester Hills, MI 48307
Phone (248) 844-9710

50438 Van Dyke Ave
Shelby Township, MI 48317
Phone (586) 726-8423

4600 Investment Dr
Ste 270
Troy, MI 48098
Phone (248) 267-6222

4600 Investment Dr
Ste 380
Troy, MI 48098
Phone (248) 267-5025

Interoperability endpoints

  • Direct secure messaging: sbologna@cdh.directglo.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265932800000",
    "number": "1972585925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 INVESTMENT DR",
            "address_2": "STE 380",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480986365",
            "telephone_number": "248-844-9710",
            "fax_number": "248-844-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 INVESTMENT DR",
            "address_2": "STE 380",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480986365",
            "telephone_number": "248-267-5025",
            "fax_number": "248-267-5026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLOGNA",
        "first_name": "SANTE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2010-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "4301406457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2839447",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.