Individual provider Active NPI

Rudram Naidu Muppuri, M.D

  • Anesthesiology Physician
  • Detroit, MI
National Provider Identifier
1184996530
Registry record updated Nov 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4301089888 Issued in MI
Practice address
3990 John R St
Detroit, MI 48201-2018
Phone
(313) 993-0822
NPI assigned
Feb 1, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Hospital 282E00000X 4301089888 MI
Long Term Care Hospital 282E00000X
Anesthesiology Physician 207L00000X 4301089888 MI Primary

Addresses

Primary practice location

3990 John R St
Detroit, MI 48201-2018

Mailing address

PO Box 64000
DWR 641546
Detroit, MI 48264-0001

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
I20120727000625 MI Practitioner - AnesthesiologyPractitioner - Pain Management 0244496743 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Services Associates PCGroup PAC ID 4385557602, 67 clinicians

Practice addresses (Care Compare)

1101 W University Dr
Crittenton Hospital Medical Center
Rochester, MI 48307-1863
Phone (248) 652-5000

11800 E 12 Mile Rd
Warren, MI 48093-3472
Phone (586) 573-5000

1221 Pine Grove Ave
Port Huron, MI 48060-3511
Phone (810) 987-5000

1221 Pine GRV
Port Huron, MI 48060-3511

21510 Harrington St
Suite 300
Clinton Township, MI 48036-2378
Phone (586) 323-4575

2775 Blake Rd
Jackson, MI 49201-8838
Phone (517) 787-2906

401 S Ballenger Hwy
Flint, MI 48532-3638
Phone (810) 342-2000

50 N Perry St
McLaren Oakland
Pontiac, MI 48342-2217
Phone (248) 338-5000

G3200 Beecher Rd
Suite 2
Flint, MI 48532-3651
Phone (810) 342-4881

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Services Associates, PC Anesthesiology CurrentSince Jul 1, 2012 Accepting new patients
Northstar Anesthesia of Michigan PLLC Anesthesiology CurrentSince Jun 1, 2015 Accepting new patients

Locations

21510 Harrington St
Ste 300
Clinton Twp, MI 48036
Phone (586) 323-4560

1990 Union Lake Rd
Ste 350
Commerce Twp, MI 48382
Phone (248) 301-5898

4201 Saint Antoine St
Detroit, MI 48201
Phone (313) 745-3615

6071 W Outer Dr
Detroit, MI 48235
Phone (313) 966-3300

3990 John R St
Detroit, MI 48201
Phone (313) 745-6211

5302 Gateway Ctr
Flint, MI 48507
Phone (810) 285-9901

1 Genesys Pkwy
Grand Blanc, MI 48439
Phone (810) 606-5733

2775 Blake Rd
Jackson, MI 49201
Phone (517) 787-2906

432 W University Dr
Rochester, MI 48307
Phone (248) 651-6122

1000 W University Dr
Ste 100
Rochester, MI 48307
Phone (248) 402-0266

5130 Coolidge Hwy
#120
Royal Oak, MI 48073
Phone (248) 288-9500

11800 E 12 Mile Rd
Warren, MI 48093
Phone (586) 573-5000

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 7

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": "1328054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353024000000",
    "number": "1184996530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64000",
            "address_2": "DWR 641546",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482640001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012018",
            "telephone_number": "313-993-0822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUPPURI",
        "first_name": "RUDRAM NAIDU",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-01",
        "last_updated": "2012-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "MI",
            "license": "4301089888",
            "primary": false
        },
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301089888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.