Active NPI
Mohan Navarasala, MD
- Diagnostic Radiology Physician
- Rochester, MI
National Provider Identifier
1306861075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 043418
- Practice address
- 1101 W University Dr
Radiology Dept
Rochester, MI 48307-1863 - Phone
- (248) 652-5325
- Fax
- (248) 652-9731
- NPI assigned
- Jul 13, 2006
- Last updated
- Sep 24, 2013
- 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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 043418 | MI | Primary |
Addresses
Primary practice location
1101 W University Dr
Radiology Dept
Rochester, MI 48307-1863
Mailing address
1101 W University Dr
Radiology Dept
Rochester, MI 48307-1863
Phone (248) 652-5325
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4398889 | Medicaid | MI |
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 |
|---|---|---|---|
| 043418 | MI | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr L Reynolds Assoc PC | Past | Accepting new patients | |
| Barbara Ann Karmanos Cancer Institute | Past | Accepting new patients | |
| Barbara Ann Karmanos Cancer Institute | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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-
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- NPI 1669423265
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379980800000",
"number": "1306861075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1101 W UNIVERSITY DR",
"address_2": "RADIOLOGY DEPT",
"city": "ROCHESTER",
"state": "MI",
"postal_code": "483071863",
"telephone_number": "248-652-5325",
"fax_number": "248-652-9731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 W UNIVERSITY DR",
"address_2": "RADIOLOGY DEPT",
"city": "ROCHESTER",
"state": "MI",
"postal_code": "483071863",
"telephone_number": "248-652-5325",
"fax_number": "248-652-9731"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAVARASALA",
"first_name": "MOHAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-13",
"last_updated": "2013-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MI",
"license": "043418",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4398889",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rochester, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.