Shabana Kalladi Puthanpurayil, M.D

Primary specialty

Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X

License

4301097882 Issued in MI

Practice address

3535 W 13 Mile Rd Ste 707
Royal Oak, MI 48073-6770

Phone

(248) 551-0487

Fax

(248) 551-3696

NPI assigned

Aug 23, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: skalladiputhanpurayil1134001@direct.hfhs.org
• Direct secure messaging: skalladiputhanpurayil1240707@epic00.shdirect.org
• Direct secure messaging: skalladiputhanpurayil474039@direct.beaumont.edu

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.

• Beaumont Medical Group- Specialty Services

  • Surgery Physician
  • Royal Oak, MI
  • NPI 1578072906
  Medicare reassignment NPD
• Oakwood Ambulatory LLC

  • Internal Medicine Physician
  • Dearborn, MI
  • NPI 1003829441

  Pediatrics

  Medicare reassignment NPD
• William Beaumont Hospital

  • General Acute Care Hospital
  • Royal Oak, MI
  • NPI 1083833875
  Medicare reassignment NPD
• Oakwood Ambulatory, LLC

  • Podiatrist
  • Westland, MI
  • NPI 1013157361
  NPD
• William Beaumont Hospital

  • Hospitalist Physician
  • Royal Oak, MI
  • NPI 1811044878
  NPD
• William Beaumont Hospital

  • General Acute Care Hospital
  • Grosse Pointe, MI
  • NPI 1932396017
  NPD
• William Beaumont Hospital

  • Physician Assistant
  • Royal Oak, MI
  • NPI 1164471983
  NPD (past)

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

{
    "created_epoch": "1314057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1376823286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 TOWN CENTER DR STE 203",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480841744",
            "telephone_number": "248-585-8250",
            "fax_number": "248-585-8270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 W 13 MILE RD STE 707",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736770",
            "telephone_number": "248-551-0487",
            "fax_number": "248-551-3696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLADI PUTHANPURAYIL",
        "first_name": "SHABANA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-23",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "MI",
            "license": "4301097882",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301097882",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skalladiputhanpurayil474039@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "3535 W 13 Mile Rd Ste 707",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480736770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tariq Kakish, MD
• Norman Johnny Kakos, MD
• Michelle Lynn Kalil, BSPT
• Rebecca Kalis
• Ellanya Lourde Kallabat
• Eleanor Kallo, LPC
• Shikha Kalra, DO
• Jeffrey C Kalt, MD
• Danielle Kamat
• Rita Marie Kamieniecki, MS, OTR/L

• Pediatric Endocrinology Physician in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Pediatric Endocrinology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.