NPIMap

Individual provider Active NPI

Chandrika Iyer, MD

  • Family Medicine Physician
  • Saint Clair Shores, MI
National Provider Identifier
1306895065
Registry record updated Mar 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301070354 Issued in MI
Practice address
21099 Masonic Blvd
Saint Clair Shores, MI 48082-1045
Phone
(586) 296-6213
Fax
(586) 296-8180
NPI assigned
May 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301070354 MI Primary

Addresses

Primary practice location

21099 Masonic Blvd
Saint Clair Shores, MI 48082-1045

Mailing address

21099 Masonic Blvd
Saint Clair Shores, MI 48082-1045
Phone (586) 296-6213

Other identifiers 2

IdentifierTypeStateIssuer
700E031610OtherMIBCBS GROUP NUMBER
4230161MedicaidMI

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
I20070314000568 MI Practitioner - Family Practice 9537262464 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health St. John HospitalGroup PAC ID 3173424082, 332 clinicians

Practice addresses (Care Compare)

21099 Masonic Blvd
Saint Clair Shores, MI 48082-1045
Phone (586) 296-6213

22101 Moross Rd
Detroit, MI 48236-2148
Phone (586) 753-0011

24911 Little Mack Ave
St CLR Shores, MI 48080-3200
Phone (586) 777-2050

46591 Romeo Plank Rd
Suite 137
Macomb, MI 48044-5743
Phone (586) 226-6269

Hospital & facility affiliations

  • Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165
  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053
  • Henry Ford Health Warren Hospital Hospital, Warren, MI, CCN 230195
  • Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301070354MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Seton Health Corporation of Southeastern Michigan Family Medicine CurrentSince Nov 18, 2016 Accepting new patients
Henry Ford Health St. John Hospital Current Accepting new patients
Henry Ford Cornerstone Medical Group Family Medicine Current Accepting new patients
Seton Health Corporation of Southeastern Michigan CurrentSince Nov 18, 2016 Accepting new patients
Henry Ford Health St. John Hospital Family Medicine Past Accepting new patients
St. John Hospital and Medical Center Family Medicine Past Accepting new patients
St. John Hospital Past Accepting new patients

Locations

46591 Romeo Plank Rd
Macomb, MI 48044
Phone (586) 226-6269

20225 E 9 Mile Rd
Ste 220
Saint Clair Shores, MI 48080

22255 Greenfield Rd
Ste 550
Southfield, MI 48075
Phone (586) 226-6161

28000 Dequindre Rd
Warren, MI 48092
Phone (586) 743-0944

Interoperability endpoints

  • Direct secure messaging: ciyer1133020@direct.hfhs.org
  • FHIR API: https://fhir-myrecord.cerner.com/r4/mQjCqHb5rkr1u1foU4dqhQPBpi7Qk9R4/

Organizations & group practices 12

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 6

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

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332720000000",
    "number": "1306895065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21099 MASONIC BLVD",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480821045",
            "telephone_number": "586-296-6213",
            "fax_number": "586-296-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21099 MASONIC BLVD",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480821045",
            "telephone_number": "586-296-6213",
            "fax_number": "586-296-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IYER",
        "first_name": "CHANDRIKA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2012-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301070354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "700E031610",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4230161",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.