Individual provider Active NPI

Puranchander Shetty, MD

  • Vascular & Interventional Radiology Physician
  • Flint, MI
National Provider Identifier
1104869312
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
4301037112 Issued in MI
Practice address
Hurley Medical Center
One Hurley Plaza, Radiology Dept
Flint, MI 48503
Phone
(810) 424-4761
Fax
(810) 424-4871
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 4301037112 MI Primary

Addresses

Primary practice location

Hurley Medical Center
One Hurley Plaza, Radiology Dept
Flint, MI 48503

Mailing address

PO Box 4459
Flint, MI 48504-0459
Phone (810) 424-4761

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ballenger Road Scanner LLC Vascular & Interventional Radiology Past Accepting new patients

Organizations & group practices 1

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1104869312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4459",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485040459",
            "telephone_number": "810-424-4761",
            "fax_number": "810-424-4871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HURLEY MEDICAL CENTER",
            "address_2": "ONE HURLEY PLAZA, RADIOLOGY DEPT",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "48503",
            "telephone_number": "810-424-4761",
            "fax_number": "810-424-4871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHETTY",
        "first_name": "PURANCHANDER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MI",
            "license": "4301037112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.