SUPAK SOOKKASIKON M.D.
NPI 1649376922
Family Medicine in Bloomfield Township, MI

Q: What is Supak Sookkasikon's NPI number?

The NPI number for Supak Sookkasikon is 1649376922. It was assigned to this individual provider in the NPPES registry on September 15, 2006.

Q: What is Supak Sookkasikon's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Supak Sookkasikon was last updated on February 28, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 15, 2006PECOS EnrolledAccepts Medicare Assignment

4050 W MAPLE RD, SUITE 101, BLOOMFIELD TOWNSHIP, MI 48301(248) 885-8211(248) 885-8357 Get Directions Write a Review

NPPES record last updated: February 28, 2014. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Supak Sookkasikon M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUPAK SOOKKASIKON M.D. (NPI 1649376922) is an individual family medicine provider in Bloomfield Township, Michigan, licensed in Michigan (4301083253) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS, is affiliated with Northwestern Medicine Central Dupage Hospital, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1649376922

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameSUPAK SOOKKASIKONCredential: M.D.

Location Address4050 W MAPLE RD, SUITE 101Bloomfield Township, MI 48301-3148

Mailing Address4050 W Maple Rd, Suite 101Bloomfield Township, MI 48301-3148 · (248) 885-8211 · Fax (248) 885-8357

Phone(248) 885-8211

Fax(248) 885-8357

Sole ProprietorYes

Medical School CMSOtherGraduated 2003

Enumeration DateSeptember 15, 2006

Last NPPES UpdateFebruary 28, 2014

✔ NPI 1649376922 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MI · 4301083253

Definition

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.

4050 W MAPLE RD, Bloomfield Township, MI 48301

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Other Identifiers 1

Other5315028426MI · Controlled Substance

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Supak Sookkasikon M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9537263132

PECOS Enrollment IDI20070409000031

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Supak Sookkasikon reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

A3 Medical

Same address

Internal Medicine

4050 W MAPLE ROAD, SUITE 101
Bloomfield, MI 48301

Reassigned Medicare billing, Michigan enrollment
5 clinicians in this Medicare group

NPI 1366798373 (248) 885-8211

A3 Primary Care

Same address

Internal Medicine

4050 W MAPLE RD STE B
Bloomfield Hills, MI 48301

Reassigned Medicare billing, Michigan enrollment
2 clinicians in this Medicare group

NPI 1780348086 (248) 885-8211

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 19

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

291 services237 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

181 services150 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus 87426

An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.

111 services106 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

107 services98 patients

Detection test by immunoassay with direct visual observation for influenza virus 87804

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

103 services50 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

81 services81 patients

X-ray of chest, 2 views 71046

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

48 services48 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

47 services41 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

43 services42 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

41 services41 patients

Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) 87880

A detection test by immunoassay for Group A Strep is a quick procedure to identify a bacterial infection in your throat. It involves taking a throat swab and applying it to a test strip, which changes color if Strep bacteria are present.

39 services38 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

36 services19 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

26 services26 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

25 services25 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

23 services23 patients

Removal of impacted ear wax 69210

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

22 services21 patients

Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen 87635

This is a lab test that detects the presence of COVID-19 in your body. It uses a technique to amplify the virus's genetic material, either DNA or RNA, making it easier to identify. A positive result indicates an active infection.

21 services20 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

14 services13 patients

X-ray of foot, minimum of 3 views 73630

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

13 services13 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Northwestern Medicine Central Dupage Hospital

Acute Care Hospitals · Winfield, IL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140242

Location25 North Winfield RoadWinfield, IL 60190 · Du Page County

Emergency services Birthing friendly

Beaumont Hospital Royal Oak

Acute Care Hospitals · Royal Oak, MI

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230130

Location3601 W Thirteen Mile RdRoyal Oak, MI 48073 · Oakland County

Emergency services Birthing friendly

Beaumont Hospital - Farmington Hills

Acute Care Hospitals · Farmington Hills, MI

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230151

Location28050 Grand River AvenueFarmington Hills, MI 48336 · Oakland County

Emergency services Birthing friendly

Beaumont Hospital, Troy

Acute Care Hospitals · Troy, MI

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230269

Location44201 Dequindre RoadTroy, MI 48085 · Oakland County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48301 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$90.76 typical visit price

range $58.04 – $177.36

Typical copayment $22.69 (range $14.51 – $44.34)

Most-billed visit code 99203

Established Patient

$102.35 typical visit price

range $18.32 – $143.49

Typical copayment $25.58 (range $4.58 – $35.87)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$69.97 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$31.21 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANGELIC ZAITOUNA

Nurse Practitioner (Family)

4050 W MAPLE RD
BLOOMFIELD HILLS, MI 48301

Oakland County (248) 885-8211

JULIE LILLEY PA-C

Physician Assistant (Medical)

4050 W MAPLE RD
BLOOMFIELD, MI 48301

Oakland County (248) 885-8211

DR. CRAIG CARLTON SPANGLER D.D.S.

Dentist (General Practice)

4050 W MAPLE RD, SUITE 220
BLOOMFIELD HILLS, MI 48301

Oakland County (248) 645-9831

KATE LYNETTE CVETKOVSKI

Physician Assistant

4050 W MAPLE RD
BLOOMFIELD HILLS, MI 48301

Oakland County (248) 885-8211

KAHN CENTER FOR CARDIAC LONGEVITY

Internal Medicine (Cardiovascular Disease)

4050 W MAPLE RD, SUITE 108
BLOOMFIELD TOWNSHIP, MI 48301

Oakland County (248) 731-7412

SAMANTHA HELENA NEAMONITIS

Nurse Practitioner (Adult Health)

4050 W MAPLE RD
BLOOMFIELD TOWNSHIP, MI 48301

Oakland County (248) 480-4402

MAPLE ORTHODONTICS, PLLC

Dentist (Orthodontics and Dentofacial Orthopedics)

4050 W MAPLE RD, SUITE 201
BLOOMFIELD HILLS, MI 48301

Oakland County (248) 646-9768

SUSAN LINDA WAINWRIGHT-ROLLINS M.D.

Psychiatry & Neurology (Psychiatry)

4050 W MAPLE RD
BLOOMFIELD HILLS, MI 48301

Oakland County (248) 258-2478

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Supak Sookkasikon's NPI number?

The NPI number for Supak Sookkasikon is 1649376922. It was assigned to this individual provider in the NPPES registry on September 15, 2006.

Where is Supak Sookkasikon located?

Supak Sookkasikon practices at 4050 W Maple Rd Suite 101, Bloomfield Township, MI 48301. The listed phone number is (248) 885-8211.

What is Supak Sookkasikon's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Supak Sookkasikon enrolled in Medicare?

Yes. Supak Sookkasikon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Supak Sookkasikon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Supak Sookkasikon reassigns Medicare benefits to 2 organizations: A3 Medical (Bloomfield, MI) and A3 Primary Care (Bloomfield Hills, MI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Supak Sookkasikon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Supak Sookkasikon accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health and UnitedHealthcare list Supak Sookkasikon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Supak Sookkasikon affiliated with any hospitals?

According to CMS data, Supak Sookkasikon is affiliated with Northwestern Medicine Central Dupage Hospital, Beaumont Hospital Royal Oak, Beaumont Hospital - Farmington Hills and Beaumont Hospital, Troy.

When was this NPI record last updated?

The NPPES record for Supak Sookkasikon was last updated on February 28, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.