Metro Detroit Renal Doctor PC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

METRO DETROIT RENAL DOCTOR PC

Practice address

1349 S Rochester Rd Ste 115
Rochester Hills, MI 48307-3151

Phone

(248) 759-4852

Fax

(248) 759-4854

NPI assigned

Sep 22, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Rakesh Lattupalli, MDNPI 1841292158

Title

Owner

Phone

(313) 247-6037

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rakesh Lattupalli, MD

  • Nephrology Physician
  • Rochester, MI
  • NPI 1841292158
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1316649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651190400000",
    "number": "1417230889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3272",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486053272",
            "telephone_number": "989-797-1400",
            "fax_number": "989-797-4077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1349 S ROCHESTER RD STE 115",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483073151",
            "telephone_number": "248-759-4852",
            "fax_number": "248-759-4854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METRO DETROIT RENAL DOCTOR PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-22",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A",
        "authorized_official_last_name": "LATTUPALLI",
        "authorized_official_first_name": "RAKESH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-247-6037",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nephrology Physician in Rochester Hills, MI
• Providers in Rochester Hills, MI by specialty
• Nephrology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.