Organization Active NPI

Ramachandra Kolachalam, MD PC

  • Surgery Physician
  • Novi, MI
National Provider Identifier
1053599860
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
RB060299 Issued in MI
Legal business name
RAMACHANDRA KOLACHALAM, MD PC
Practice address
26850 Providence Pkwy
#460
Novi, MI 48374-1209
Phone
(586) 751-6034
NPI assigned
Feb 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Authorized official

Name
Ramachandra Kolachalam, MDNPI 1386687010
Title
President
Phone
(586) 751-6034

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X RB060299 MI Primary

Addresses

Primary practice location

26850 Providence Pkwy
#460
Novi, MI 48374-1209

Mailing address

26850 Providence Pkwy
#460
Novi, MI 48374-1209
Phone (586) 751-6034

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080521000714 MI Part B Supplier - Clinic/Group Practice 2567531189 Receives reassigned benefits from 1 practitioner
Practice locations: Novi, MI

National Provider Directory

National Provider Directory

Locations

22250 Providence Dr
Ste 703
Southfield, MI 48075
Phone (248) 557-5717

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1053599860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26850 PROVIDENCE PKWY",
            "address_2": "#460",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741209",
            "telephone_number": "586-751-6034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26850 PROVIDENCE PKWY",
            "address_2": "#460",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741209",
            "telephone_number": "586-751-6034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAMACHANDRA KOLACHALAM, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-04",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "KOLACHALAM",
        "authorized_official_first_name": "RAMACHANDRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-751-6034",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "MI",
            "license": "RB060299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.