Organization Active NPI

Sanjeev Venkataraman, MD, PLC

  • Psychiatry Physician
  • Bloomfield Hills, MI
National Provider Identifier
1447640792
Registry record updated Jan 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
SV056477 Issued in MI
Legal business name
SANJEEV VENKATARAMAN, MD, PLC
Practice address
4111 Andover Rd Ste 220
Bloomfield Hills, MI 48302-1909
Phone
(248) 290-5400
Fax
(248) 290-5401
NPI assigned
Jan 26, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2015

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

Authorized official

Name
Sanjeev Venkataraman, MDNPI 1629120282
Title
Doctor
Phone
(248) 290-5400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X SV056477 MI Primary

Addresses

Primary practice location

4111 Andover Rd Ste 220
Bloomfield Hills, MI 48302-1909

Mailing address

4111 Andover Rd Ste 220
Bloomfield Hills, MI 48302-1909
Phone (248) 290-5400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150331002662 MI Part B Supplier - Clinic/Group Practice 7416274469 Receives reassigned benefits from 2 practitioners
Practice locations: Bloomfield Township, MI; New Baltimore, MI

National Provider Directory

National Provider Directory

Locations

W-4111 Andover Rd
Ste 100
Bloomfield Township, MI 48302
Phone (248) 290-5400

4111 Andover Rd
Ste 220
Bloomfield Township, MI 48302
Phone (248) 290-5400

W-4111 Andover Rd
Ste 125
Bloomfield Township, MI 48302
Phone (248) 737-4525

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1422230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422230400000",
    "number": "1447640792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 ANDOVER RD STE 220",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483021909",
            "telephone_number": "248-290-5400",
            "fax_number": "248-290-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 ANDOVER RD STE 220",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483021909",
            "telephone_number": "248-290-5400",
            "fax_number": "248-290-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANJEEV VENKATARAMAN, MD, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-26",
        "last_updated": "2015-01-26",
        "status": "A",
        "authorized_official_last_name": "VENKATARAMAN",
        "authorized_official_first_name": "SANJEEV",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "248-290-5400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "SV056477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2015; 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.