Active NPI
Vinaya Vallabhaneni, M.D.
- Occupational Medicine Physician
- Detroit, MI
National Provider Identifier
1295875342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Medicine Physician
- License
- 4301065655
- Practice address
- Henry Ford Health System
2799 West Grand Boulevard
Detroit, MI 48202 - Phone
- (313) 916-9106
- Fax
- (313) 916-1249
- NPI assigned
- Feb 7, 2007
- 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 |
|---|---|---|---|---|
| Occupational Medicine Physician | 2083X0100X | 4301065655 | MI | Primary |
Addresses
Primary practice location
Henry Ford Health System
2799 West Grand Boulevard
Detroit, MI 48202
Mailing address
Henry Ford Health System
2799 West Grand Boulevard
Detroit, MI 48202
Phone (313) 916-9106
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| VV065655 | Other | CHAMPUS-CHAMPUS | |
| VV065655 | Other | COMMERCIAL-COMMERCIAL NUMBER |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pennview Medical Clinic,Inc. | Past | Accepting new patients | |
| Primary Care Center PLLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Preferred Provider Organization
- Riverview, MI
- NPI 1386846160
-
- Family Medicine Physician
- Dearborn Heights, MI
- NPI 1780292623
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295875342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HENRY FORD HEALTH SYSTEM",
"address_2": "2799 WEST GRAND BOULEVARD",
"city": "DETROIT",
"state": "MI",
"postal_code": "48202",
"telephone_number": "313-916-9106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "HENRY FORD HEALTH SYSTEM",
"address_2": "2799 WEST GRAND BOULEVARD",
"city": "DETROIT",
"state": "MI",
"postal_code": "48202",
"telephone_number": "313-916-9106",
"fax_number": "313-916-1249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALLABHANENI",
"first_name": "VINAYA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "MI",
"license": "4301065655",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS-CHAMPUS",
"identifier": "VV065655",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMERCIAL-COMMERCIAL NUMBER",
"identifier": "VV065655",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.