NPIMap

Individual provider Active NPI

Sailaja Datla, MD

  • Internal Medicine Physician
  • Saint Clair Shores, MI
National Provider Identifier
1154434975
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301070545 Issued in MI
Practice address
24800 Harper Ave Ste 1
Saint Clair Shores, MI 48080-1292
Phone
(586) 445-3706
Fax
(586) 445-3709
NPI assigned
Aug 16, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301070545 MI Primary

Addresses

Primary practice location

24800 Harper Ave Ste 1
Saint Clair Shores, MI 48080-1292

Mailing address

24800 Harper Ave Ste 1
Saint Clair Shores, MI 48080-1292
Phone (586) 445-3706

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091006000387 MI Practitioner - Internal Medicine 4981740933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Complete Care Rehab LLCGroup PAC ID 2466423637, 12 clinicians

Practice addresses (Care Compare)

24800 Harper Ave
Saint Clair Shores, MI 48080-1292
Phone (586) 445-3706

31370 Harper Ave
Saint Clair Shores, MI 48082-2450

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.55 of 100Reported as group
Quality
80.19
Promoting interoperability
48
Improvement activities
40
Cost
58.29

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sailaja Datla MD PLC Internal Medicine CurrentSince Oct 1, 2001 Accepting new patients
Henry Ford Health St. John Hospital Past Accepting new patients
Haranath Policherla M.D. PC PastSince Jun 3, 2015 Accepting new patients
Med Share Inc Past Accepting new patients
Pointe Medical Center PC Past Accepting new patients

Locations

24800 Harper Ave
Ste 1
Saint Clair Shores, MI 48080
Phone (586) 445-3706

24800 Harper Ave
St Clr Shores, MI 48080
Phone (313) 775-8603

Interoperability endpoints

  • Direct secure messaging: sdatla986429@direct.hfhs.org

Organizations & group practices 6

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.

Hospital & facility affiliations 9

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1154434975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24800 HARPER AVE STE 1",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801292",
            "telephone_number": "586-445-3706",
            "fax_number": "586-445-3709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24800 HARPER AVE STE 1",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801292",
            "telephone_number": "586-445-3706",
            "fax_number": "586-445-3709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATLA",
        "first_name": "SAILAJA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301070545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.