NPIMap

Individual provider Active NPI

Shivanhalli Prakash, MD

  • Surgery Physician
  • Clinton TWP, MI
National Provider Identifier
1245343250
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
SP407447 Issued in MI
Practice address
43311 Commons Dr
Clinton TWP, MI 48038-1109
Phone
(586) 263-8555
Fax
(586) 263-8558
NPI assigned
Aug 16, 2006
Last updated
Oct 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X SP407447 MI Primary

Addresses

Primary practice location

43311 Commons Dr
Clinton TWP, MI 48038-1109

Mailing address

43311 Commons Drive
Clinton Township, MI 48038-1109
Phone (586) 263-8555

Other names 1

  • Shivana Prakash Other 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
I20060126000137 MI Practitioner - General Surgery 8820012495 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

15717 15 Mile Rd
Clinton Township, MI 48035-2101

15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone (586) 263-2300

43311 Commons Dr
Clinton Township, MI 48038-1109
Phone (586) 263-8555

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement1-10
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux19
Removal of tissue13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP407447MIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Macomb Hospital Corporation CurrentSince Feb 5, 2013 Accepting new patients
Pioneer Medical Associates P.C. CurrentSince Jan 1, 2023 Accepting new patients
Henry Ford Macomb Hospital Corporation Current Accepting new patients
Paramount Medical Group PC Current Accepting new patients
Shivana N. Prakash MDPC Surgery CurrentSince Nov 1, 2005 Accepting new patients
Pioneer Endoscopy & Surgery Center, L.L.C. CurrentSince Jan 1, 2023 Accepting new patients
Henry Ford Macomb Hospital Corporation Surgery CurrentSince Feb 5, 2013 Accepting new patients
St. Clair Medical Associates, P.C. Past Accepting new patients

Locations

15945 19 Mile Rd
Ste 206
Clinton Township, MI 48038
Phone (586) 228-6603

15717 15 Mile Rd
Clinton Twp, MI 48035
Phone (586) 285-3800

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

15945 19 Mile Rd
Ste 204
Clinton Twp, MI 48038
Phone (586) 757-6400

43311 Commons Dr
Clinton Twp, MI 48038
Phone (586) 263-0610

27560 Hoover Rd
Warren, MI 48093
Phone (586) 573-5890

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JDIBBA
  • Direct secure messaging: shivana.prakash@direct.meditouchehr.com
  • Direct secure messaging: sprakash63432@direct.hfhs.org

Organizations & group practices 8

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 2

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": "1730246400000",
    "number": "1245343250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43311 COMMONS DRIVE",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381109",
            "telephone_number": "586-263-8555",
            "fax_number": "586-263-8558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43311 COMMONS DR",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480381109",
            "telephone_number": "586-263-8555",
            "fax_number": "586-263-8558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRAKASH",
        "first_name": "SHIVANHALLI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "SP407447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHIVANA",
            "last_name": "PRAKASH",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Clinton TWP, MI

Sources for this page

Verify at the official NPI Registry.