Individual provider Active NPI

Vijayanirmala Yedulla, M.D.

  • Internal Medicine Physician
  • Livonia, MI
National Provider Identifier
1346210119
Registry record updated Apr 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301078978 Issued in MI
Practice address
36123 Schoolcraft Rd
Livonia, MI 48150-1216
Phone
(734) 464-0887
Fax
(734) 402-0254
NPI assigned
Jan 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301078978 MI Primary

Addresses

Primary practice location

36123 Schoolcraft Rd
Livonia, MI 48150-1216

Mailing address

36123 Schoolcraft Rd
Livonia, MI 48150-1216
Phone (734) 464-0887

Other identifiers 1

IdentifierTypeStateIssuer
4742820MedicaidMI

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
I20050805000322 MI Practitioner - Internal Medicine 8921037490 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan Post-Acute Medical Services 1 PCGroup PAC ID 2163798877, 25 clinicians
Mi Pacs 2 PCGroup PAC ID 2264831577, 18 clinicians

Practice addresses (Care Compare)

22600 W Main St
Armada, MI 48005-3237
Phone (734) 508-4569

555 Highland Ave
Milford, MI 48381-1517
Phone (248) 684-1564

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.72 of 100Reported as apm
Quality
72.97
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301078978MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Post-Acute Medical Services 1 PC CurrentSince Sep 11, 2017 Accepting new patients
CS Pacs 3 Midwest LLC Internal Medicine CurrentSince Oct 21, 2024 Accepting new patients
Inpatient Consultants of Michigan PC Internal Medicine CurrentSince May 26, 2010 Accepting new patients
Mi Pacs 2 PC CurrentSince Jun 1, 2021 Accepting new patients
Armada Mi Opco LLC Past Accepting new patients
Richmond Opco LLC Past Accepting new patients
Macomb County Human Services Board-an Agency of Macomb County Past Accepting new patients

Locations

22600 W Main St
Armada, MI 48005
Phone (734) 508-4569

1014 E Grand River Ave
Brighton, MI 48116
Phone (810) 220-5222

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

1 William Carls Dr
Commerce Twp, MI 48382
Phone (248) 227-5500

23550 Haggerty Rd
Farmington Hills, MI 48335
Phone (248) 381-8081

28050 Grand River Ave
Farmington Hills, MI 48336
Phone (248) 471-8000

G3201 Beecher Rd
Flint, MI 48532
Phone (810) 732-9200

12200 Broadbent Rd
Lansing, MI 48917
Phone (517) 731-6200

36123 Schoolcraft Rd
Livonia, MI 48150
Phone (734) 793-6140

3310 W Commerce Rd
Milford, MI 48380
Phone (248) 685-1400

555 Highland Ave
Milford, MI 48381
Phone (248) 684-1564

1211 Stateline Rd
Niles, MI 49120
Phone (269) 684-2810

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042

6827 Whitehall Rd
Whitehall, MI 49461
Phone (231) 893-8730

625 36th St SW
Wyoming, MI 49509
Phone (517) 481-3715

Organizations & group practices 7

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": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1346210119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36123 SCHOOLCRAFT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501216",
            "telephone_number": "734-464-0887",
            "fax_number": "734-402-0254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36123 SCHOOLCRAFT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501216",
            "telephone_number": "734-464-0887",
            "fax_number": "734-402-0254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEDULLA",
        "first_name": "VIJAYANIRMALA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301078978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4742820",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.