Individual provider Active NPI

Girish Gandikota, MD

  • Diagnostic Radiology Physician
  • Ann Arbor, MI
National Provider Identifier
1114007903
Registry record updated Dec 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4301084734 Issued in MI
Practice address
1500 East Medical Center Dr
2ND Floor Taubman Center Recp a
Ann Arbor, MI 48109-5326
Phone
(734) 936-4500
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 4301084734 MI Primary

Addresses

Primary practice location

1500 East Medical Center Dr
2ND Floor Taubman Center Recp a
Ann Arbor, MI 48109-5326

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other identifiers 1

IdentifierTypeStateIssuer
4702324MedicaidMI

Other names 1

  • Gandikota Girish Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050411000263 MI Practitioner - Diagnostic Radiology 0941247100 Reassigns benefits to 1 organization
I20220907001204 NC Practitioner - Diagnostic Radiology 0941247100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of North Carolina at Chapel HillGroup PAC ID 0648181156, 2,028 clinicians

Practice addresses (Care Compare)

101 Manning Dr
Chapel Hill, NC 27514-4220
Phone (984) 974-1000

Hospital & facility affiliations

  • Unc Hospitals Hospital, Chapel Hill, NC, CCN 340061
  • Chatham Hospital Inc Hospital, Siler City, NC, CCN 341311

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301084734MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Hospital CurrentSince Dec 22, 2018 Accepting new patients
University of North Carolina at Chapel Hill CurrentSince Jul 16, 2022 Accepting new patients

Locations

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

5221 Paramount Pkwy
Ste 420
Morrisville, NC 27560
Phone (984) 215-6533

Interoperability endpoints

  • Direct secure messaging: ggandikota840051@direct.unc.nchie.net

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544659200000",
    "number": "1114007903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 EAST MEDICAL CENTER DR",
            "address_2": "2ND FLOOR TAUBMAN CENTER RECP A",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095326",
            "telephone_number": "734-936-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDIKOTA",
        "first_name": "GIRISH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2018-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301084734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4702324",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GANDIKOTA",
            "last_name": "GIRISH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.