NPIMap

Individual provider Active NPI

Shruti Konda Devineni, DO

  • Internal Medicine Physician
  • Howell, MI
National Provider Identifier
1053873539
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101026924 Issued in MI
Practice address
Iha Howell Primary Care
202 W Highland Rd.
Howell, MI 48843
Phone
(517) 234-6540
Fax
(517) 338-9083
NPI assigned
Apr 3, 2019
Last updated
Jan 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101026924 MI Primary

Addresses

Primary practice location

Iha Howell Primary Care
202 W Highland Rd.
Howell, MI 48843

Mailing address

24 Frank Lloyd Wright Drive
Lobby J2000
Ann Arbor, MI 48105
Phone (734) 747-6766

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220624001890 MI Practitioner - Family PracticePractitioner - Internal Medicine 9830424068 Reassigns benefits to 2 organizations
I20240104001045 IL Practitioner - Internal Medicine 9830424068 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2900 Hannah Blvd
Suite 114
East Lansing, MI 48823-5380
Phone (517) 364-8080

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Services Corporation Internal Medicine CurrentSince Sep 1, 2022 Accepting new patients
Lakeview Immediate Care LLC CurrentSince Nov 20, 2023 Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients
Edward W Sparrow Hospital Association CurrentSince Aug 15, 2025 Accepting new patients
Edward W. Sparrow Hospital Association CurrentSince Aug 15, 2025 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Iha Health Service Corporation CurrentSince Sep 1, 2022 Accepting new patients
Edward W. Sparrow Hospital Association Past Accepting new patients

Locations

1645 W School St
Ste A
Chicago, IL 60657
Phone (773) 227-3669

8175 Reliable Pkwy
Chicago, IL 60686

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840

2900 Hannah Blvd
Ste 114
East Lansing, MI 48823
Phone (517) 364-8080

202 W M 59
Howell, MI 48843
Phone (517) 234-6540

Organizations & group practices 8

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 6

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": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1053873539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DRIVE",
            "address_2": "LOBBY J2000",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48105",
            "telephone_number": "734-747-6766",
            "fax_number": "734-222-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "IHA HOWELL PRIMARY CARE",
            "address_2": "202 W HIGHLAND RD.",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "48843",
            "telephone_number": "517-234-6540",
            "fax_number": "517-338-9083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVINENI",
        "first_name": "SHRUTI",
        "middle_name": "KONDA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-03",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101026924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Howell, MI

Sources for this page

Verify at the official NPI Registry.