Gaurav Sanjay Suryawanshi, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Minneapolis, Minnesota. His current practice location is
420 Delaware St Se, Minneapolis, Minnesota. You can reach out to his office (for appointments etc.) via phone at
(612) 625-8999.
Gaurav Sanjay Suryawanshi is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1164042446.
Physician's Profile
Full Name | Gaurav Sanjay Suryawanshi |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 420 Delaware St Se, Minneapolis, Minnesota |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1164042446
- Provider Enumeration Date: 04/16/2020
- Last Update Date: 05/17/2024
Medicare PECOS Information:
- PECOS PAC ID: 8123445418
- Enrollment ID: I20230628002507
Medical Identifiers
Medical identifiers for Gaurav Sanjay Suryawanshi such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1164042446 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207R00000X | Internal Medicine | 74423 (Minnesota) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Gaurav Sanjay Suryawanshi allows following entities to bill medicare on his behalf.
Entity Name | Fairview Health Services |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1013994359 PECOS PAC ID: 1951213057 Enrollment ID: O20031105000461 |
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Entity Name | Fairview Clinics |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1346432218 PECOS PAC ID: 7113830142 Enrollment ID: O20031106000516 |
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Entity Name | Healtheast Medical Research Institute |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1639125503 PECOS PAC ID: 3971407636 Enrollment ID: O20031124000507 |
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Entity Name | Fairview Express Care |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1053952606 PECOS PAC ID: 3375645179 Enrollment ID: O20081028000548 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Gaurav Sanjay Suryawanshi is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Gaurav Sanjay Suryawanshi, MD 420 Delaware St Se, Mmc 36, Minneapolis, MN 55455 Ph: (612) 625-8999 | Gaurav Sanjay Suryawanshi, MD 420 Delaware St Se, Minneapolis, MN 55455-0341 Ph: (612) 625-8999 |
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