NPIMap

Individual provider Active NPI

Nithin S Peddireddy, MD

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Detroit, MI
National Provider Identifier
1326530866
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
License
4301511303 Issued in MI
Practice address
4100 John R St
Detroit, MI 48201-2013
Phone
(800) 527-6266
NPI assigned
May 31, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 35.147752 OH
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X 4301511303 MI Primary

Addresses

Primary practice location

4100 John R St
Detroit, MI 48201-2013

Mailing address

4100 John R St
Detroit, MI 48201-2013
Phone (800) 527-6266

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
I20240604000572 MI Practitioner - Otolaryngology 1355696576 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Cincinnati College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren FlintGroup PAC ID 8628975497, 144 clinicians
Barbara Ann Karmanos Cancer InstituteGroup PAC ID 3870407901, 57 clinicians

Practice addresses (Care Compare)

4100 Beecher Rd
Suite B
Flint, MI 48532-3661
Phone (810) 235-8568

4100 John R St
Detroit, MI 48201-2013
Phone (800) 527-6266

Hospital & facility affiliations

  • McLaren Flint Hospital, Flint, MI, CCN 230141
  • Karmanos Cancer Center Hospital, Detroit, MI, CCN 230297
  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
  • Hurley Medical Center Hospital, Flint, MI, CCN 230132

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision17
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Barbara Ann Karmanos Cancer Institute CurrentSince Jul 19, 2024 Accepting new patients
McLaren Flint CurrentSince Jul 19, 2024 Accepting new patients
Barbara Ann Karmanos Cancer Institute CurrentSince Jul 19, 2024 Accepting new patients
McLaren Flint CurrentSince Jul 19, 2024 Accepting new patients
Barbara Ann Karmanos Cancer Institute Past Accepting new patients
McLaren Flint Past Accepting new patients

Locations

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

31995 Northwestern Hwy
Farmington Hills, MI 48334
Phone (248) 538-4701

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

4100 Beecher Rd
Ste B
Flint, MI 48532
Phone (810) 235-8568

4100 Beecher Rd
Ste A
Flint, MI 48532
Phone (810) 342-3800

30550 Utica Rd
Roseville, MI 48066
Phone (586) 771-0290

Organizations & group practices 6

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": "1527724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1326530866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012013",
            "telephone_number": "800-527-6266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012013",
            "telephone_number": "800-527-6266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDDIREDDY",
        "first_name": "NITHIN",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-31",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": "35.147752",
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "MI",
            "license": "4301511303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.