SUSAN JURASEK M.D. NPI 1528019155

NPI Information

NPI: 1528019155
Provider Name: SUSAN JURASEK, M.D.
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
19020 FORT ST
RIVERVIEW, MI
ZIP 48193
Phone: (734) 362-5100
Get Directions

Susan Jurasek, M.D. is a family medicine in Riverview, MI. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Susan Jurasek, M.D. NPI is 1528019155. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

19020 FORT ST
RIVERVIEW, MI
ZIP 48193-701
Phone: (734) 362-5100
Fax: (734) 362-5147

The NPI 1528019155 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/16/2006 and was last updated on 2/17/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		4301076380	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	16362	OTHER	MICHIGAN	MCARE
2	383268406	OTHER	MICHIGAN	EIN TAX ID#
3	0M17170017	MEDICARE ID-TYPE UNSPECIFIED	MICHIGAN
4	7160529	OTHER	MICHIGAN	AETNA
5	700H21076	OTHER	MICHIGAN	BCBSM
6	4621100	MEDICAID	MICHIGAN
7	4301076380	OTHER	MICHIGAN	PHYSICIAN LICENSE
8	136932	OTHER	MICHIGAN	MERCY CARE CHOICES
9	CC3713	OTHER	MICHIGAN	RR MEDICARE
10	2366034	OTHER	MICHIGAN	UHC
11	6675152	OTHER	MICHIGAN	CIGNA
12	H89100	MEDICARE UPIN	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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