Kondraganti P Rao, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

4301032931 Issued in MI

Practice address

28111 Hoover
Warren, MI 48093

Phone

(586) 573-0589

Fax

(586) 573-3861

NPI assigned

Mar 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

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.

• Eastside Group LLC

  • Anesthesiology Physician
  • Saint Clair Shores, MI
  • NPI 1235365289
  Medicare reassignment NPD
• Nsa Pain Services of Michigan III, PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Taylor, MI
  • NPI 1376169524
  Medicare reassignment NPD
• Northstar Anesthesia of Michigan III PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Irving, TX
  • NPI 1972126209

  MI

  Medicare reassignment NPD
• Michigan Healthcare Professionals PC

  • Durable Medical Equipment & Medical Supplies
  • Lapeer, MI
  • NPI 1992693303
  NPD (past)

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1306814561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 N DEEPLANDS ROAD",
            "city": "GROSSE POINTE SHORES",
            "state": "MI",
            "postal_code": "48236",
            "telephone_number": "586-573-0589",
            "fax_number": "586-573-3861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28111 HOOVER",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48093",
            "telephone_number": "586-573-0589",
            "fax_number": "586-573-3861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAO",
        "first_name": "KONDRAGANTI",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MI",
            "license": "4301032931",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301032931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2627454",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Frederick Ramus, PA-C
• Denise Randall, RPH
• Emma Rose Randall, MD
• Aneel Kaur Randhawa, D.D.S.
• Chakrapani Ranganathan, M.D.
• Chris Spero Raphtis, MD
• Lauren Rash
• Saadiqa Rasheed
• Jennifer Marie Rathousky, D.O.
• Michelle Lynn Ratkov

• Anesthesiology Physician in Warren, MI
• Providers in Warren, MI by specialty
• Anesthesiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.