Active NPI
Prasanth Talluri
- Psychiatry Physician
- Pontiac, MI
National Provider Identifier
1023799319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 4351052046
- Practice address
- 461 W Huron St
Pontiac, MI 48341-1601 - Phone
- (248) 857-6700
- NPI assigned
- Jul 28, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 4351052046 | MI | Primary |
Addresses
Primary practice location
461 W Huron St
Pontiac, MI 48341-1601
Mailing address
461 W Huron St
Pontiac, MI 48341-1601
Phone (248) 857-6700
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250819003741 | MI | Order and Referring Only - Psychiatry | 6709385313 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1690502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690502400000",
"number": "1023799319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "461 W HURON ST",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483411601",
"telephone_number": "248-857-6700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "461 W HURON ST",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483411601",
"telephone_number": "248-857-6700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TALLURI",
"first_name": "PRASANTH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-07-28",
"last_updated": "2023-07-28",
"certification_date": "2023-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "4351052046",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pontiac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.