Kishore B Kondapaneni, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4301058857 Issued in MI

Practice address

690 S Trumbull
Bay City, MI 48708

Phone

(989) 922-4900

Fax

(989) 922-4911

NPI assigned

Aug 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kondapaneni.kishore.001.0220017@mbpa.meditab.direct-ci.com

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.

• Michigan Psyciatric & Behavioral Associates

  dba Mpba

  • Psychologist
  • Bay City, MI
  • NPI 1144322496
  Authorized official Same address or phone
• Michigan Psyciatric & Behavioral Associates PC

  • Psychiatry Physician
  • Bay City, MI
  • NPI 1326194168
  NPD (past) Authorized official
• List Psychological Services, PLC

  • Clinical Social Worker
  • Sandusky, MI
  • NPI 1174267116

  Psychiatry

  NPD (past)
• McLaren Bay Region

  • Psychologist
  • Essexville, MI
  • NPI 1013056233
  NPD (past)
• Tuscola County Community Mental Health Services Board

  dba Tuscola Behavioral Health Systems

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Caro, MI
  • NPI 1275644775
  NPD (past)

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360886400000",
    "number": "1093722977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 S TRUMBULL",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "48708",
            "telephone_number": "989-922-4900",
            "fax_number": "989-922-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 S TRUMBULL",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "48708",
            "telephone_number": "989-922-4900",
            "fax_number": "989-922-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONDAPANENI",
        "first_name": "KISHORE",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2013-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301058857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLUS",
            "identifier": "2602960690",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "N34080004",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4318064",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5972098",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "260Z910350",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "90196",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachael Kokaly
• Jennilee Kolb
• Kaleb Isaac Kolb
• Kristi Kolka
• Mark C Komorowski, MD
• Joseph Benjamin Konsdorf
• Brandy Kontowsky
• Kaylee Jo Koons
• Emma Rhae Koscielski
• Brianna Kosecki, DDS

• Psychiatry Physician in Bay City, MI
• Providers in Bay City, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2013; 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.