Individual provider Active NPI

Madaiah Kusuma-Talakadu, M.D.

  • Pediatrics Physician
  • Monroe, MI
National Provider Identifier
1053620617
Registry record updated Sep 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301096025 Issued in MI
Practice address
814 N Macomb St
Monroe, MI 48162-3085
Phone
(734) 243-5720
Fax
(734) 243-9261
NPI assigned
Sep 30, 2010
Last updated
Sep 30, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301096025 MI Primary

Addresses

Primary practice location

814 N Macomb St
Monroe, MI 48162-3085

Mailing address

814 N Macomb St
Monroe, MI 48162-3085
Phone (734) 243-5720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301096025MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Memorial Hospital Corporatio Past Accepting new patients
Ped PC Pediatrics Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1285804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285804800000",
    "number": "1053620617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 N MACOMB ST",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481623085",
            "telephone_number": "734-243-5720",
            "fax_number": "734-243-9261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 N MACOMB ST",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481623085",
            "telephone_number": "734-243-5720",
            "fax_number": "734-243-9261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSUMA-TALAKADU",
        "first_name": "MADAIAH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-30",
        "last_updated": "2010-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301096025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.