Individual provider Active NPI

Madhumitha Krishnamoorthy

  • Family Medicine Physician
  • Southfield, MI
National Provider Identifier
1124438445
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
43011053135 Issued in MI
Practice address
26400 W 12 Mile Rd Ste 110
Southfield, MI 48034-1771
Phone
(734) 707-8086
NPI assigned
May 8, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 43011053135 MI Primary

Addresses

Primary practice location

26400 W 12 Mile Rd Ste 110
Southfield, MI 48034-1771

Mailing address

26400 W 12 Mile Rd Ste 110
Southfield, MI 48034-1771

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
I20171107000196 MI Practitioner - Family Practice 0840581559 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
VHS Physicians of MichiganGroup PAC ID 8921289760, 219 clinicians

Practice addresses (Care Compare)

2455 Union Lake Rd
Commerce Township, MI 48382-3596

3901 Beaubien 1St Floor
Detroit, MI 48201-2119
Phone (313) 745-5227

3901 Beaubien St
Detroit, MI 48201-2119

Hospital & facility affiliations

  • Huron Valley-Sinai Hospital Hospital, Commerce Township, MI, CCN 230277
  • Sinai-Grace Hospital Hospital, Detroit, MI, CCN 230024

Merit-based Incentive Payment System (MIPS)

Final score
90.26 of 100Reported as group
Quality
64.16
Promoting interoperability
100
Improvement activities
40
Cost
73.79

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43011053135MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nexgen Vitality PLLC Family Medicine Current Accepting new patients
VHS Physicians of Michigan CurrentSince Oct 3, 2017 Accepting new patients

Locations

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

19460 Grand River Ave
Detroit, MI 48223
Phone (313) 387-1097

26400 W 12 Mile Rd
Ste 110
Southfield, MI 48034
Phone (248) 355-3875

Interoperability endpoints

  • Direct secure messaging: madhumitha.krishnamoorthy.1@9704.direct.athenahealth.com

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 2

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": "1399507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1124438445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26400 W 12 MILE RD STE 110",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26400 W 12 MILE RD STE 110",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341771",
            "telephone_number": "734-707-8086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISHNAMOORTHY",
        "first_name": "MADHUMITHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-08",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "43011053135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.