Individual provider Active NPI

Beena Nagappala, M.D.

  • Family Medicine Physician
  • Clinton Township, MI
National Provider Identifier
1366434318
Registry record updated Dec 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301074847 Issued in MI
Practice address
42645 Garfield Rd
Suite 103
Clinton Township, MI 48038-5022
Phone
(586) 286-0050
Fax
(586) 286-0880
NPI assigned
Aug 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2007

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 4301074847 MI Primary

Addresses

Primary practice location

42645 Garfield Rd
Suite 103
Clinton Township, MI 48038-5022

Mailing address

42645 Garfield Rd
Suite 103
Clinton Township, MI 48038-5022
Phone (586) 286-0050

Other identifiers 1

IdentifierTypeStateIssuer
4612530MedicaidMI

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
I20040618001341 MI Practitioner - Family Practice 0042295669 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Semi Medical GroupGroup PAC ID 0648180406, shared by 4 NPIs, 246 clinicians
Henry Ford Cornerstone Medical GroupGroup PAC ID 7517162761, 65 clinicians

Practice addresses (Care Compare)

17900 23 Mile Rd
Macomb, MI 48044-1161
Phone (313) 647-3900

43900 Garfield Rd
Suite 222
Clinton Township, MI 48038-1137
Phone (586) 286-0050

Hospital & facility affiliations

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301074847MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Southeast Michigan Community Health CurrentSince Jan 1, 2021 Accepting new patients
Henry Ford Health St. John Hospital Family Medicine CurrentSince Apr 1, 2021 Accepting new patients
Henry Ford Health St. John Hospital Current Accepting new patients
Henry Ford Cornerstone Medical Group Family Medicine CurrentSince Jan 1, 2016 Accepting new patients
Henry Ford Southeast Michigan Community Health CurrentSince Jan 1, 2021 Accepting new patients

Locations

4260 Van Dyke Rd
Ste 102
Almont, MI 48003
Phone (810) 798-3994

42645 Garfield Rd
Ste 103
Clinton Twp, MI 48038
Phone (586) 286-0050

43900 Garfield Rd
Ste 222
Clinton Twp, MI 48038
Phone (586) 263-1234

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

2301 Van Dyke St
Detroit, MI 48214
Phone (313) 264-6497

1726 Howard St
Detroit, MI 48216
Phone (313) 338-3740

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

Interoperability endpoints

  • Direct secure messaging: bnagappala241766@direct.hfhs.org
  • FHIR API: https://fhir-myrecord.cerner.com/r4/mQjCqHb5rkr1u1foU4dqhQPBpi7Qk9R4/
  • Direct secure messaging: beena.nagappala.2@8209.direct.athenahealth.com

Organizations & group practices 5

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 5

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197936000000",
    "number": "1366434318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42645 GARFIELD RD",
            "address_2": "SUITE 103",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480385022",
            "telephone_number": "586-286-0050",
            "fax_number": "586-286-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42645 GARFIELD RD",
            "address_2": "SUITE 103",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480385022",
            "telephone_number": "586-286-0050",
            "fax_number": "586-286-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGAPPALA",
        "first_name": "BEENA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2007-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301074847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4612530",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

Verify at the official NPI Registry.