Individual provider Active NPI

Anjana Myneni, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Bloomfield Hills, MI
National Provider Identifier
1316063274
Registry record updated Nov 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
4301087510 Issued in MI
Practice address
43494 Woodward Ave
Suite 208
Bloomfield Hills, MI 48302-5052
Phone
(248) 335-7740
Fax
(248) 338-7979
NPI assigned
Mar 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 4301087510 MI Primary

Addresses

Primary practice location

43494 Woodward Ave
Suite 208
Bloomfield Hills, MI 48302-5052

Mailing address

43494 Woodward Ave
Suite 208
Bloomfield Hills, MI 48302-5052
Phone (248) 335-7740

Other identifiers 1

IdentifierTypeStateIssuer
N50760005OtherMIMEDICARE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110726000831 MI Practitioner - Endocrinology 8426114430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Grunberger Diabetes Medical Center PCGroup PAC ID 9739175530, 3 clinicians

Practice addresses (Care Compare)

43494 Woodward Ave
Suite 208
Bloomfield Hills, MI 48302-5054
Phone (248) 335-7740

Hospital & facility affiliations

  • Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029
  • Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269
  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grunberger Diabetes Medical Center, PC Endocrinology, Diabetes & Metabolism CurrentSince Aug 1, 2011 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

43494 Woodward Ave
Ste 2
Bloomfld Hls, MI 48302

43494 Woodward Ave
Ste 208
Bloomfld Hls, MI 48302
Phone (248) 335-7740

Interoperability endpoints

  • Direct secure messaging: amyneni25230@direct.trinity-health.org

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.

Hospital & facility affiliations 4

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": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321920000000",
    "number": "1316063274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43494 WOODWARD AVE",
            "address_2": "SUITE 208",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483025052",
            "telephone_number": "248-335-7740",
            "fax_number": "248-338-7979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43494 WOODWARD AVE",
            "address_2": "SUITE 208",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483025052",
            "telephone_number": "248-335-7740",
            "fax_number": "248-338-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYNENI",
        "first_name": "ANJANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2011-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MI",
            "license": "4301087510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "N50760005",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

Verify at the official NPI Registry.