Individual provider Active NPI

Nithin Thummala, M.D.

  • Diagnostic Radiology Physician
  • Detroit, MI
National Provider Identifier
1194954867
Registry record updated Jul 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4301094794 Issued in MI
Practice address
4201 Saint Antoine St RM 3L-8
Detroit, MI 48201-2153
Phone
(313) 745-3430
NPI assigned
Jul 2, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 4301094794 MI Primary

Addresses

Primary practice location

4201 Saint Antoine St RM 3L-8
Detroit, MI 48201-2153

Mailing address

4201 Saint Antoine St RM 3L-8
Detroit, MI 48201-2153
Phone (313) 745-3430

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
I20150708002560 MI Practitioner - Diagnostic Radiology 3577875202 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Wayne State University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Medical GroupGroup PAC ID 3971416082, 240 clinicians
Barbara Ann Karmanos Cancer InstituteGroup PAC ID 3870407901, 57 clinicians

Practice addresses (Care Compare)

32901 23 Mile Rd
Suite 120
Chesterfield, MI 48047-4032
Phone (586) 725-4604

4100 John R St
Detroit, MI 48201-2013
Phone (800) 527-6266

416 Connable Ave
Petoskey, MI 49770-2212
Phone (517) 975-6475

Hospital & facility affiliations

  • Karmanos Cancer Center Hospital, Detroit, MI, CCN 230297
  • McLaren Northern Michigan Hospital, Petoskey, MI, CCN 230105
  • McLaren Bay Region Hospital, Bay City, MI, CCN 230041
  • McLaren Central Michigan Hospital, Mount Pleasant, MI, CCN 230080
  • Harper University Hospital Hospital, Detroit, MI, CCN 230104

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Barbara Ann Karmanos Cancer Institute CurrentSince Jul 15, 2015 Accepting new patients
McLaren Medical Group CurrentSince Mar 19, 2024 Accepting new patients
McLaren Medical Group Diagnostic Radiology CurrentSince Mar 19, 2024 Accepting new patients
Barbara Ann Karmanos Cancer Institute Past Accepting new patients

Locations

32901 23 Mile Rd
Ste 120
Chesterfield, MI 48047
Phone (586) 725-4604

39373 Garfield Rd
Clinton Twp, MI 48038
Phone (586) 286-4880

4201 Saint Antoine St
Rm 3L8
Detroit, MI 48201
Phone (313) 745-3430

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

31995 Northwestern Hwy
Farmington Hills, MI 48334
Phone (248) 538-4701

24601 Northwestern Hwy
Southfield, MI 48075
Phone (248) 304-2902

Organizations & group practices 4

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 6

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": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278547200000",
    "number": "1194954867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST RM 3L-8",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-3430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST RM 3L-8",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-3430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THUMMALA",
        "first_name": "NITHIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-02",
        "last_updated": "2010-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301094794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.