Active NPI
Muthayipalayam C Thirumoorthi, MD
- Pediatric Infectious Diseases Physician
- Detroit, MI
National Provider Identifier
1124012943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Infectious Diseases Physician
- License
- 4301034927
- Practice address
- 22201 Moross Rd
270
Detroit, MI 48236-2169 - Phone
- (313) 343-3481
- Fax
- (313) 343-7937
- NPI assigned
- Sep 8, 2005
- 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 |
|---|---|---|---|---|
| Pediatric Infectious Diseases Physician | 2080P0208X | 4301034927 | MI | Primary |
Addresses
Primary practice location
22201 Moross Rd
270
Detroit, MI 48236-2169
Mailing address
43800 Garfield Rd
Clinton TWP, MI 48038-1136
Phone (586) 228-4635
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1880500 | Medicaid | MI | |
| 4301034927 | Other | CONTROLLED SUBSTANCE | |
| 1266139 | Other | ECFMG |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4301034927 | MI | MD | Pediatric Infectious Diseases Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. John Hospital | Past | Accepting new patients |
Interoperability endpoints
- mthirumoorthi1155476@direct.hfhs.org
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.
-
- General Acute Care Hospital
- Detroit, MI
- NPI 1649355918
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184803200000",
"number": "1124012943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43800 GARFIELD RD",
"city": "CLINTON TWP",
"state": "MI",
"postal_code": "480381136",
"telephone_number": "586-228-4635",
"fax_number": "586-226-6949"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22201 MOROSS RD",
"address_2": "270",
"city": "DETROIT",
"state": "MI",
"postal_code": "482362169",
"telephone_number": "313-343-3481",
"fax_number": "313-343-7937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THIRUMOORTHI",
"first_name": "MUTHAYIPALAYAM",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-08",
"last_updated": "2007-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0208X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Infectious Diseases",
"state": "MI",
"license": "4301034927",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1880500",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONTROLLED SUBSTANCE",
"identifier": "4301034927",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ECFMG",
"identifier": "1266139",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.