Individual provider Active NPI

Priti Verma, M.D.

  • Internal Medicine Physician
  • Troy, MI
National Provider Identifier
1336149004
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301070837 Issued in MI
Practice address
4967 Crooks Rd
Suite 130
Troy, MI 48098-5801
Phone
(248) 952-1601
Fax
(248) 952-0192
NPI assigned
Jul 26, 2005
Last updated
Oct 16, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301070837 MI Primary
Hospitalist Physician 208M00000X 4301070837 MI

Addresses

Primary practice location

4967 Crooks Rd
Suite 130
Troy, MI 48098-5801

Mailing address

4967 Crooks Rd
Suite 130
Troy, MI 48098-5801
Phone (248) 952-1601

Other identifiers 3

IdentifierTypeStateIssuer
4829501MedicaidMI
1336149004OtherMINPI #
PV070837OtherMIBCBSM

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
I20130601000024 MI Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 4688604267

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301070837MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Michigan PC Internal Medicine Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1336149004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4967 CROOKS RD",
            "address_2": "SUITE 130",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480985801",
            "telephone_number": "248-952-1601",
            "fax_number": "248-952-0192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4967 CROOKS RD",
            "address_2": "SUITE 130",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480985801",
            "telephone_number": "248-952-1601",
            "fax_number": "248-952-0192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERMA",
        "first_name": "PRITI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-26",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301070837",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MI",
            "license": "4301070837",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4829501",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI #",
            "identifier": "1336149004",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "PV070837",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.