Active NPI
Gireesh Velugubanti, M.D.
- Neurology with Special Qualifications in Child Neurology Physician
- Southfield, MI
National Provider Identifier
1104081397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology with Special Qualifications in Child Neurology Physician
- License
- 4301087670
- Practice address
- 21700 Northwestern Hwy Ste 150
Southfield, MI 48075-4906 - Phone
- (419) 777-8260
- Fax
- (947) 282-1112
- NPI assigned
- Jul 28, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 4301087670 | MI | |
| Neurology with Special Qualifications in Child Neurology Physician | 2084N0402X | 4301087670 | MI | Primary |
Addresses
Primary practice location
21700 Northwestern Hwy Ste 150
Southfield, MI 48075-4906
Mailing address
44648 Mound Rd Ste 131
Sterling Heights, MI 48314-1322
Phone (419) 777-8260
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578934600 | Other | MI | NPI-2 ORGANIZATION |
Other names 1
- Dr. Gireesh Velugubanti
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301087670 | MI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Diagnostic Solutions | Current | Accepting new patients | |
| City Med Clinic LLC | Past | Accepting new patients |
Locations
30400 Telegraph Rd
Ste 360
Bingham Farms, MI 48025
44648 Mound Rd
Sterling Heights, MI 48314
Phone (248) 522-2279
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 and National Provider Directory roles.
-
- Radiology Clinic/Center
- Sterling Heights, MI
- NPI 1437676871
-
- Clinic/Center
- Detroit, MI
- NPI 1134361702
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743379200000",
"number": "1104081397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44648 MOUND RD STE 131",
"city": "STERLING HEIGHTS",
"state": "MI",
"postal_code": "483141322",
"telephone_number": "419-777-8260",
"fax_number": "947-282-1112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21700 NORTHWESTERN HWY STE 150",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480754906",
"telephone_number": "419-777-8260",
"fax_number": "947-282-1112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VELUGUBANTI",
"first_name": "GIREESH",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-28",
"last_updated": "2025-03-31",
"certification_date": "2025-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "4301087670",
"primary": false
},
{
"code": "2084N0402X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
"state": "MI",
"license": "4301087670",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI-2 ORGANIZATION",
"identifier": "1578934600",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "GIREESH",
"last_name": "VELUGUBANTI",
"prefix": "DR.",
"credential": "M.D.",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.