Individual provider Active NPI

Madhav R Kapila

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1104389675
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101026668 Issued in MI
Practice address
22201 Moross Rd Ste 50
Detroit, MI 48236-2166
Phone
(313) 343-7774
Fax
(313) 343-8747
NPI assigned
Apr 10, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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 5101026668 MI Primary

Addresses

Primary practice location

22201 Moross Rd Ste 50
Detroit, MI 48236-2166

Mailing address

22201 Moross Rd Ste 50
Detroit, MI 48236-2166

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220616001129 MI Practitioner - Internal Medicine 8325371743 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital CurrentSince Jun 15, 2022 Accepting new patients
Henry Ford Health St. John Hospital Internal Medicine CurrentSince Jun 15, 2022 Accepting new patients
Pathology Specialists of Southeast Michigan PC Current Accepting new patients
Procare Partners Health PLLC Internal Medicine CurrentSince Jul 1, 2023 Accepting new patients
Henry Ford Health St. John Hospital Current Accepting new patients

Locations

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

19251 Mack Ave
Ste 333
Grosse Pointe Woods, MI 48236
Phone (313) 343-7280

22201 Moross Rd
Ste 50
Grosse Pointe Woods, MI 48236
Phone (313) 343-7774

3611 Carpenter St
Ste 5
Hamtramck, MI 48212
Phone (313) 733-8286

2800 Livernois Rd
Ste 500
Troy, MI 48083
Phone (586) 753-0400

11885 E 12 Mile Rd
Ste 200B
Warren, MI 48093
Phone (586) 576-4145

Organizations & group practices 5

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": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1104389675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22201 MOROSS RD STE 50",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22201 MOROSS RD STE 50",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362166",
            "telephone_number": "313-343-7774",
            "fax_number": "313-343-8747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPILA",
        "first_name": "MADHAV",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-10",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101026668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.