Active NPI
Venkateswara Rao Malineni, MD
- Psychiatry Physician
- Mt Clemens, MI
National Provider Identifier
1265467682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 283787-1
- Practice address
- 215 North Ave
St Joseph Specialty Hospital 215
Mt Clemens, MI 48045 - Phone
- (586) 466-9889
- Fax
- (586) 466-9972
- NPI assigned
- Jul 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 283787-1 | NY | Primary |
Addresses
Primary practice location
215 North Ave
St Joseph Specialty Hospital 215
Mt Clemens, MI 48045
Mailing address
5341 Provincial Dr
Bloomfield Hills, MI 48302
Phone (888) 495-3999
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 296306310 | Medicaid | MI | |
| 2606320151 | Other | MI | BC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 283787-1 | NY | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baddigam Family Psychiatric Associates PLLC | Psychiatry | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychiatry Physician
- Clinton Township, MI
- NPI 1093899569
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522281600000",
"number": "1265467682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5341 PROVINCIAL DR",
"city": "BLOOMFIELD HILLS",
"state": "MI",
"postal_code": "48302",
"telephone_number": "888-495-3999",
"fax_number": "586-466-9972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 NORTH AVE",
"address_2": "ST JOSEPH SPECIALTY HOSPITAL 215",
"city": "MT CLEMENS",
"state": "MI",
"postal_code": "48045",
"telephone_number": "586-466-9889",
"fax_number": "586-466-9972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALINENI",
"first_name": "VENKATESWARA",
"middle_name": "RAO",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-12",
"last_updated": "2018-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "283787-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "296306310",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC",
"identifier": "2606320151",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mt Clemens, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.