Individual provider Active NPI

Satish Babu Nagelli, PA-C

  • Physician Assistant
  • Sterling Heights, MI
National Provider Identifier
1053105429
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
39393 Van Dyke Ave Ste 101
Sterling Heights, MI 48313-4636
Phone
(313) 403-8787
NPI assigned
Apr 8, 2025
Last updated
Apr 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

39393 Van Dyke Ave Ste 101
Sterling Heights, MI 48313-4636

Mailing address

39393 Van Dyke Ave Ste 101
Sterling Heights, MI 48313-4636

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250911001786 MI Practitioner - Physician Assistant 9335642842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

137 Rue Village Rd
Maurice, LA 70555-3453

18000 W 9 Mile Rd
Suite 620
Southfield, MI 48075-4017

39880 Van Dyke Ave
Suite 202
Sterling Heights, MI 48313-4670

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 1

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

Hospital & facility affiliations 2

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": "1744070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1053105429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39393 VAN DYKE AVE STE 101",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483134636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39393 VAN DYKE AVE STE 101",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483134636",
            "telephone_number": "313-403-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGELLI",
        "first_name": "SATISH",
        "middle_name": "BABU",
        "name_prefix": "Dr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-08",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

Verify at the official NPI Registry.