Shivana N. Prakash MDPC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

SP407447 Issued in MI

Legal business name

SHIVANA N. PRAKASH MDPC

Practice address

43311 Commons Dr
Clinton TWP, MI 48038-1109

Phone

(586) 263-8555

Fax

(586) 263-8558

NPI assigned

Jan 8, 2007

Organization subpart

No

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

Authorized official

Name

Shivana N Prakash, MD

Title

General Surgeon

Phone

(586) 263-8555

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

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

• Shivanhalli Prakash, MD

  • Surgery Physician
  • Clinton TWP, MI
  • NPI 1245343250
  Medicare reassignment NPD

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730246400000",
    "number": "1457409971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43311 COMMONS DR",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480381109",
            "telephone_number": "586-263-8555",
            "fax_number": "586-263-8558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43311 COMMONS DR",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480381109",
            "telephone_number": "586-263-8555",
            "fax_number": "586-263-8558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIVANA N. PRAKASH MDPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A",
        "authorized_official_last_name": "PRAKASH",
        "authorized_official_first_name": "SHIVANA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "GENERAL SURGEON",
        "authorized_official_telephone_number": "586-263-8555",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "MI",
            "license": "SP407447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3180584",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Enkeleda Shehu
• Carol Ann Sherwood, PTA, COTAL
• Robert W Shick Jr., OD
• Raymond Shin, D.C.
• Shishir Senapati MD PC
• Steven D Shoha, D.D.S.
• Marvin Shulman, MD, PC
• Claire Rebecca Sickon, PT
• Bailey Sikora, MOT, OTR/L
• Silver Circle Counseling and Therapeutic Services, PLLC

• Surgery Physician in Clinton TWP, MI
• Providers in Clinton TWP, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; 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.