Individual provider Active NPI

Gireesh Velugubanti, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Southfield, MI
National Provider Identifier
1104081397
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
4301087670 Issued in MI
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

Updated by the provider on Mar 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1578934600OtherMINPI-2 ORGANIZATION

Other names 1

  • Dr. Gireesh Velugubanti Professional name

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

LicenseStateTypeSpecialty
4301087670MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Solutions CurrentSince Jan 1, 2023 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.

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.

Verify at the official NPI Registry.