NPIMap

Individual provider Active NPI

Mahesha Makandura, M.D.

  • Rheumatology Physician
  • Novi, MI
National Provider Identifier
1235593682
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
4301501798 Issued in MI
Practice address
39450 W 12 Mile Rd
Novi, MI 48377-3600
Phone
(248) 344-6688
NPI assigned
Apr 12, 2016
Last updated
Sep 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 4301501798 MI Primary

Addresses

Primary practice location

39450 W 12 Mile Rd
Novi, MI 48377-3600

Mailing address

1 Ford PL Ste 3a
Detroit, MI 48202-3450

Other practice location 1

6071 W Outer Dr
Detroit, MI 48235-2624
Phone (313) 966-6777

Other names 1

  • MP Mahesha Lakmali Mudannayaka Former name

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
I20230428001559 MI Practitioner - RheumatologyPractitioner - Internal Medicine 6103117940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Semi Medical GroupGroup PAC ID 0648180406, shared by 4 NPIs, 246 clinicians
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

17900 23 Mile Rd
Macomb, MI 48044-1161
Phone (313) 647-3900

39450 W 12 Mile Rd
Novi, MI 48377-3600
Phone (248) 344-6688

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Current Accepting new patients
Henry Ford Health System Rheumatology CurrentSince Apr 24, 2023 Accepting new patients
Henry Ford Health System CurrentSince Apr 24, 2023 Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients

Locations

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

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

39450 W Twelve Mile Rd
Novi, MI 48377
Phone (248) 344-2300

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

Interoperability endpoints

  • Direct secure messaging: mmakandura843594@direct.hfhs.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1460419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1235593682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39450 W 12 MILE RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483773600",
            "telephone_number": "248-344-6688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6071 W Outer Dr",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482352624",
            "country_code": "US",
            "telephone_number": "313-966-6777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAKANDURA",
        "first_name": "MAHESHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-12",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MI",
            "license": "4301501798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MP MAHESHA",
            "last_name": "MUDANNAYAKA",
            "middle_name": "LAKMALI",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Novi, MI

Sources for this page

Verify at the official NPI Registry.