NPIMap

Individual provider Active NPI

Sreelatha Penumalee, MD

  • Nephrology Physician
  • Warren, MI
National Provider Identifier
1396753372
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
4301073957 Issued in MI
Practice address
11900 Twelve Mile Road
Suite 200
Warren, MI 48093
Phone
(586) 558-9033
Fax
(586) 573-4209
NPI assigned
Aug 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 4301073957 MI Primary

Addresses

Primary practice location

11900 Twelve Mile Road
Suite 200
Warren, MI 48093

Mailing address

11900 Twelve Mile Road
Suite 200
Warren, MI 48093
Phone (586) 558-9033

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
I20050221000351 MI Practitioner - NephrologyPractitioner - Internal Medicine 2668424433 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metropolitan Nephrologists PCGroup PAC ID 2466418215, 9 clinicians

Practice addresses (Care Compare)

11885 E 12 Mile Rd
Warren, MI 48093-3467
Phone (586) 558-9033

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Nephrologists PC Nephrology CurrentSince Jul 1, 2004 Accepting new patients
Henry Ford Health Macomb Oakland Hospital Past Accepting new patients
Henry Ford Health Macomb Oakland Hospital Past Accepting new patients

Locations

11885 E 12 Mile Rd
Ste 302B
Warren, MI 48093
Phone (586) 558-9033

11900 E 12 Mile Rd
Ste 200
Warren, MI 48093
Phone (586) 558-9033

Interoperability endpoints

  • Direct secure messaging: spenumalee36146@direct.trinity-health.org
  • Direct secure messaging: spenumalee1144285@direct.hfhs.org

Organizations & group practices 3

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 9

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396753372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11900 TWELVE MILE ROAD",
            "address_2": "SUITE 200",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48093",
            "telephone_number": "586-558-9033",
            "fax_number": "586-573-4209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 TWELVE MILE ROAD",
            "address_2": "SUITE 200",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48093",
            "telephone_number": "586-558-9033",
            "fax_number": "586-573-4209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENUMALEE",
        "first_name": "SREELATHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "4301073957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.