NPIMap

Individual provider Active NPI

Krishna Pothugunta, M.D

  • Internal Medicine Physician
  • Troy, MI
National Provider Identifier
1285869982
Registry record updated Feb 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301093847 Issued in MI
Practice address
4600 Investment Dr
Suite 290
Troy, MI 48098-6365
Phone
(248) 267-5010
NPI assigned
May 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301093847 MI Primary
Nephrology Physician 207RN0300X 4301093847 MI

Addresses

Primary practice location

4600 Investment Dr
Suite 290
Troy, MI 48098-6365

Mailing address

4600 Investment Dr
Suite 290
Troy, MI 48098-6365
Phone (248) 267-5010

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
I20140603002359 MI Practitioner - NephrologyPractitioner - Internal Medicine 1759504111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan Kidney Consultants PCGroup PAC ID 1052207115, 45 clinicians

Practice addresses (Care Compare)

1701 S Blvd E
Suite 320
Rochester Hills, MI 48307-6117
Phone (248) 290-3345

3475 Starr Rd
Royal Oak, MI 48073-2100
Phone (248) 290-3111

4600 Investment Dr
Suite 290
Troy, MI 48098-6374
Phone (248) 267-5010

Hospital & facility affiliations

  • DaVita Starrwood Dialysis Dialysis facility, Royal Oak, MI, CCN 232708
  • DaVita Starrwood HT at Home Dialysis facility, Royal Oak, MI, CCN 232710
  • Fresenius Kidney Care Beaumont Health - Sterling Heights Dialysis facility, Sterling Heights, MI, CCN 232733
  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
  • Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269
  • Beaumont Hospital - Grosse Pointe Hospital, Grosse Pointe, MI, CCN 230089
  • Beaumont Hospital - Farmington Hills Hospital, Farmington Hills, MI, CCN 230151

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301093847MIMDNephrology Physician

Interoperability endpoints

  • Direct secure messaging: kpothugunta19033@direct.acumenmd.com

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1243296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454457600000",
    "number": "1285869982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 INVESTMENT DR",
            "address_2": "SUITE 290",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480986365",
            "telephone_number": "248-267-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 INVESTMENT DR",
            "address_2": "SUITE 290",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480986365",
            "telephone_number": "248-267-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTHUGUNTA",
        "first_name": "KRISHNA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-26",
        "last_updated": "2016-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301093847",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "4301093847",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.