Active NPI
Balajee Goutam Nallamothu, M.D.
- Anesthesiology Physician
- Royal Oak, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 4301061524
- Practice address
- 3601 W 13 Mile Rd
Royal Oak, MI 48073-6712 - Phone
- (248) 898-1905
- Fax
- (248) 898-1032
- NPI assigned
- Jun 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 4301061524 | MI | Primary |
Addresses
Primary practice location
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Mailing address
1631 W Big Beaver Rd
Troy, MI 48084-3501
Phone (248) 458-0400
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Wayne State University School of Medicine, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
18100 Oakwood Blvd
Suite 100
Dearborn, MI 48124-4085
Phone (734) 212-3097
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301061524 | MI | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Long Lake Anesthesiology Consultants, PLC | Anesthesiology | Current | Accepting new patients |
| Waterford Anesthesia, PLLC | Anesthesiology | Current | Accepting new patients |
| Motor City Anesthesia Services PLLC | Anesthesiology | Current | Accepting new patients |
| Apex Anesthesia Services PLLC | Past | Accepting new patients | |
| United Pain Therapies PLLC | Anesthesiology | Past | Accepting new patients |
| Waterford Surgical Center, LLC | Past | Accepting new patients | |
| Bloomfield Anesthesia, PC | Anesthesiology | Past | Accepting new patients |
Locations
2009 Momentum Pl
Chicago, IL 60689
18100 Oakwood Blvd
Ste 100
Dearborn, MI 48124
Phone (313) 240-7668
1546 Callis Rd
Lapeer, MI 48446
Phone (810) 667-4000
920 River Centre Dr
Port Huron, MI 48060
Phone (810) 984-5200
4550 Investment Dr
Ste 100
Troy, MI 48098
Phone (248) 265-4600
5220 Highland Rd
Ste 100
Waterford, MI 48327
Phone (248) 461-2800
5220 Highland Rd
Ste 1
Waterford, MI 48327
Phone (248) 886-5555
Organizations & group practices 7
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.
-
- Anesthesiology Physician
- Dearborn, MI
- NPI 1457058125
-
- Anesthesiology Physician
- Troy, MI
- NPI 1194812651
-
- Anesthesiology Physician
- Waterford, MI
- NPI 1376862474
-
- Certified Registered Nurse Anesthetist
- Clarkston, MI
- NPI 1811121221
-
- Anesthesiology Physician
- Pontiac, MI
- NPI 1063451839
-
- Interventional Pain Medicine Physician
- Canton, MI
- NPI 1427483403
Anesthesiology
-
- Ambulatory Surgical Clinic/Center
- Waterford, MI
- NPI 1467788729
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187308800000",
"number": "1104863414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1631 W BIG BEAVER RD",
"city": "TROY",
"state": "MI",
"postal_code": "480843501",
"telephone_number": "248-458-0400",
"fax_number": "248-458-0310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3601 W 13 MILE RD",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480736712",
"telephone_number": "248-898-1905",
"fax_number": "248-898-1032"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NALLAMOTHU",
"first_name": "BALAJEE",
"middle_name": "GOUTAM",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-02",
"last_updated": "2007-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MI",
"license": "4301061524",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Royal Oak, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.