Active NPI
Madhumita Jena Mohanty, MD
- Nephrology Physician
- Detroit, MI
National Provider Identifier
1144267741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 4301069697
- Practice address
- 4646 John R St
Detroit, MI 48201 - Phone
- (313) 576-1000
- NPI assigned
- Jun 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 4301069697 | MI | |
| Nephrology Physician | 207RN0300X | 4301069697 | MI | Primary |
Addresses
Primary practice location
4646 John R St
Detroit, MI 48201
Mailing address
4646 John R
Detroit, MI 48201
Phone (313) 576-1000
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 |
|---|---|---|---|
| 4301069697 | MI | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Physician Group | Internal Medicine | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528329600000",
"number": "1144267741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4646 JOHN R",
"city": "DETROIT",
"state": "MI",
"postal_code": "48201",
"telephone_number": "313-576-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4646 JOHN R ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "48201",
"telephone_number": "313-576-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOHANTY",
"first_name": "MADHUMITA",
"middle_name": "JENA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-01",
"last_updated": "2018-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "4301069697",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "MI",
"license": "4301069697",
"primary": true
}
],
"identifiers": [],
"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 Jun 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.