Individual provider Active NPI

Subramanyam Yadam, M.D.

  • Pulmonary Disease Physician
  • Midland, MI
National Provider Identifier
1023126448
Registry record updated Nov 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
SY038909 Issued in MI
Practice address
4201 Campus Ridge Drive
Midland, MI 48640
Phone
(989) 488-5450
Fax
(989) 488-5455
NPI assigned
Aug 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X SY038909 MI
Pulmonary Disease Physician 207RP1001X SY038909 MI Primary

Addresses

Primary practice location

4201 Campus Ridge Drive
Midland, MI 48640

Mailing address

4201 Campus Ridgedrive
Midland, MI 48640
Phone (989) 488-5450

Other identifiers 2

IdentifierTypeStateIssuer
2905610541OtherMIBLUE CROSS BLUE SHIELD
2120984MedicaidMI

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
I20080626000045 MI Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 9234201823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mymichigan Medical Center MidlandGroup PAC ID 2264323633, 507 clinicians

Practice addresses (Care Compare)

4000 Wellness Dr
Midland, MI 48670-2000
Phone (989) 633-8018

4100 Campus Ridge Dr
Midland, MI 48640-6139
Phone (989) 839-3060

4500 Campus Ridge Dr
Midland, MI 48640-6123
Phone (989) 837-9250

515 Quarter St
Gladwin, MI 48624-1959
Phone (989) 426-9286

703 N McEwan St
Clare, MI 48617-1440
Phone (989) 802-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SY038909MIMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Midland CurrentSince May 1, 2015 Accepting new patients
Mymichigan Medical Center Midland CurrentSince May 1, 2015 Accepting new patients

Locations

515 Quarter St
Gladwin, MI 48624
Phone (989) 246-6201

609 Quarter St
Gladwin, MI 48624
Phone (989) 246-6371

815 N Clare Ave
Harrison, MI 48625
Phone (989) 539-4096

4201 Campus Ridge Dr
Ste 2000
Midland, MI 48640
Phone (989) 839-1795

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

4201 N Campus Ridge Dr
Midland, MI 48640
Phone (989) 488-5450

4500 N Campus Ridge Dr
Midland, MI 48640
Phone (989) 837-9250

4100 Campus Ridge Dr
Midland, MI 48640
Phone (989) 488-5450

2618 W Sugnet Rd
Midland, MI 48640
Phone (989) 633-5237

Interoperability endpoints

  • Direct secure messaging: syadam7097@mymichiganhealth.midirect.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1156550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1023126448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 CAMPUS RIDGEDRIVE",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "48640",
            "telephone_number": "989-488-5450",
            "fax_number": "989-488-5455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 CAMPUS RIDGE DRIVE",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "48640",
            "telephone_number": "989-488-5450",
            "fax_number": "989-488-5455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YADAM",
        "first_name": "SUBRAMANYAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-26",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MI",
            "license": "SY038909",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MI",
            "license": "SY038909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "2905610541",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2120984",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.