NPIMap

Individual provider Active NPI

Praveen Kumar Kamaraju, M.D.

  • Internal Medicine Physician
  • Bay City, MI
National Provider Identifier
1083687842
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301072588 Issued in MI
Practice address
3720 Katalin Court
Bay City, MI 48706
Phone
(989) 686-2800
Fax
(989) 686-5920
NPI assigned
Feb 10, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 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 4301072588 MI Primary

Addresses

Primary practice location

3720 Katalin Court
Bay City, MI 48706

Mailing address

3720 Katalin Court
Bay City, MI 48706
Phone (989) 686-2800

Other identifiers 2

IdentifierTypeStateIssuer
4594915MedicaidMI
4301072588OtherMISTATE PHYSICIAN LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040524000073 MI Practitioner - Internal Medicine 2860483278 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Bay Medical Center PLLCGroup PAC ID 3274989306, 3 clinicians
Bay Area Health Clinic PCGroup PAC ID 1850373242, 3 clinicians

Practice addresses (Care Compare)

2394 Midland Rd
Bay City, MI 48706-9402
Phone (989) 684-2303

3720 Katalin CT
Bay City, MI 48706-2160
Phone (989) 686-2800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301072588MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Area Health Clinic PC Internal Medicine CurrentSince Jul 1, 2004 Accepting new patients
Nuclear Cardiac Imaging, LLC CurrentSince Dec 9, 2014 Accepting new patients
West Bay Medical Center PLLC Internal Medicine CurrentSince Aug 30, 2023 Accepting new patients
Nuclear Cardiac Imaging, LLC CurrentSince Dec 9, 2014 Accepting new patients
Sterling Opco LLC Past Accepting new patients
Peplinski Investment Inc Past Accepting new patients
McLaren Bay Region Past Accepting new patients
Great Lakes Bay Health Centers Past Accepting new patients
McLaren Primary Care Past Accepting new patients
Great Lakes Bay Health Centers Past Accepting new patients
Bay Shores Nursing Center, LLC Past Accepting new patients

Locations

1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000

1900 Columbus Ave
#H
Bay City, MI 48708
Phone (989) 894-3000

2394 Midland Rd
Bay City, MI 48706
Phone (989) 671-3502

3720 Katalin Ct
Bay City, MI 48706
Phone (989) 391-9223

3720 Katalin Ct
Ste 100
Bay City, MI 48706
Phone (989) 778-1425

3720 Katalin Ct
Ste 201
Bay City, MI 48706
Phone (989) 686-2800

6700 Westside Saginaw Rd
Bay City, MI 48706
Phone (989) 667-9800

Interoperability endpoints

  • Direct secure messaging: kamaraju.praveen.002.0220025@bahc.meditab.direct-ci.com
  • Direct secure messaging: kamaraju.praveen.006.0220025@bahc.meditab.direct-ci.com

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
McLaren Bay RegionBay City, MI, CCN 230041 Hospital Corporate Director Mar 3, 2025
McLaren Bay RegionBay City, MI, CCN 23S041 Hospital Corporate Officer Jun 11, 2025
McLaren Bay RegionBay City, MI, CCN 23T041 Hospital Corporate Director Mar 3, 2025
Huron Woods Nursing CenterKawkawlin, MI, CCN 235592 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2017
Jan 1, 2017

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 11

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1083687842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3720 KATALIN COURT",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "48706",
            "telephone_number": "989-686-2800",
            "fax_number": "989-686-5920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 KATALIN COURT",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "48706",
            "telephone_number": "989-686-2800",
            "fax_number": "989-686-5920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMARAJU",
        "first_name": "PRAVEEN",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2023-03-07",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301072588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4594915",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHYSICIAN LICENSE",
            "identifier": "4301072588",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay City, MI

Sources for this page

Verify at the official NPI Registry.