Sarat Chandra Khandavalli, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

4301097445 Issued in MI

Practice address

5900 Byron Center Ave SW
Wyoming, MI 49519-9606

Phone

(616) 252-7166

NPI assigned

Jun 25, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pathology

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pathology Associates of Grand Rapids PCGroup PAC ID 5698677573, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Michigan Health - West Hospital, Wyoming, MI, CCN 230236
• Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
• Trinity Health Muskegon Hospital Hospital, Muskegon, MI, CCN 230066
• Beaumont Hospital - Grosse Pointe Hospital, Grosse Pointe, MI, CCN 230089
• Corewell Health Big Rapids Hospital Hospital, Big Rapids, MI, CCN 230093

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Pathology Associates of Grand Rapids, P.C.

  • Anatomic Pathology & Clinical Pathology Physician
  • Grand Rapids, MI
  • NPI 1184636821
  Medicare reassignment Care Compare group NPD Authorized official

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

• Mecosta County Medical Center

  • General Acute Care Hospital
  • Big Rapids, MI
  • NPI 1316945991
  Care Compare affiliation
• Mercy Health Partners

  • General Acute Care Hospital
  • Muskegon, MI
  • NPI 1831132133
  Care Compare affiliation
• Metropolitan Hospital

  • General Acute Care Hospital
  • Wyoming, MI
  • NPI 1619923919
  Care Compare affiliation
• Pennock Hospital

  • Critical Access Hospital
  • Hastings, MI
  • NPI 1932695525
  Care Compare affiliation
• Spectrum Health Hospitals

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1922090554
  Care Compare affiliation
• William Beaumont Hospital

  • Hospitalist Physician
  • Royal Oak, MI
  • NPI 1811044878
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Grosse Pointe, MI
  • NPI 1932396017
  Care Compare affiliation

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1295996916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1629",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458021629",
            "telephone_number": "877-378-4293",
            "fax_number": "419-223-2726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199606",
            "telephone_number": "616-252-7166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Jefferson Ave SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495034502",
            "country_code": "US",
            "telephone_number": "616-685-6258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHANDAVALLI",
        "first_name": "SARAT",
        "middle_name": "CHANDRA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-25",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "4301097445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11295996916",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skhandavalli186729@direct.trinity-health.org",
            "affiliation": "N",
            "address_1": "200 Jefferson Ave SE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495034502",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skhandavalli33604@direct.metrohealth.net",
            "affiliation": "N",
            "address_1": "5900 Byron Center Ave SW",
            "city": "Wyoming",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495199606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Anatomic Pathology & Clinical Pathology Physician in Wyoming, MI
• Providers in Wyoming, MI by specialty
• Anatomic Pathology & Clinical Pathology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.