NPIMap

Individual provider Active NPI

Veena Panthangi, M.D.

  • Family Medicine Physician
  • Saint Clair Shores, MI
National Provider Identifier
1467571463
Registry record updated Mar 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301081639 Issued in MI
Practice address
21099 Masonic Blvd
Saint Clair Shores, MI 48082-1045
Phone
(586) 296-6213
Fax
(586) 286-8180
NPI assigned
Mar 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301081639 MI Primary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 4301081639 MI

Addresses

Primary practice location

21099 Masonic Blvd
Saint Clair Shores, MI 48082-1045

Mailing address

21099 Masonic Blvd
Saint Clair Shores, MI 48082-1045
Phone (586) 296-6213

Other identifiers 4

IdentifierTypeStateIssuer
5186442MedicaidMI
VP081639OtherMIMICHIGAN PHYSICIAN LICENS
700E011730OtherMIBCBSM GROUP NUMBER
700E031610OtherMIBCBS GROUP NUMBER

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
I20070728000064 MI Practitioner - Family PracticePractitioner - Geriatric Medicine 7113028523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health St. John HospitalGroup PAC ID 3173424082, 332 clinicians

Practice addresses (Care Compare)

21099 Masonic Blvd
Saint Clair Shores, MI 48082-1045
Phone (586) 296-6213

22101 Moross Rd
Detroit, MI 48236-2148
Phone (586) 753-0011

46591 Romeo Plank Rd
Suite 137
Macomb, MI 48044-5743
Phone (586) 226-6269

Hospital & facility affiliations

  • Residential Home Health Home health agency, Troy, MI, CCN 237459
  • Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165
  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053
  • Henry Ford Health Warren Hospital Hospital, Warren, MI, CCN 230195
  • The Orchards at Harper Woods Nursing home, Harper Woods, MI, CCN 235480

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301081639MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital CurrentSince Oct 22, 2011 Accepting new patients
Henry Ford Cornerstone Medical Group Family Medicine Current Accepting new patients
Henry Ford Health St. John Hospital Family Medicine CurrentSince Oct 22, 2011 Accepting new patients
Henry Ford Health St. John Hospital Current Accepting new patients
St. John Hospital Past Accepting new patients
Henry Ford Health St. John Hospital Family Medicine Past Accepting new patients
St. John Hospital and Medical Center Family Medicine Past Accepting new patients
Harper Woods Mi Opco LLC Past Accepting new patients

Locations

42645 Garfield Rd
Ste 103
Clinton Twp, MI 48038
Phone (586) 286-0050

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

46591 Romeo Plank Rd
Ste 133
Macomb, MI 48044
Phone (586) 226-6161

46591 Romeo Plank Rd
Macomb, MI 48044
Phone (586) 226-6269

20225 E 9 Mile Rd
Ste 220
Saint Clair Shores, MI 48080

21099 Masonic Blvd
St Clr Shores, MI 48082
Phone (586) 296-6213

28000 Dequindre Rd
Warren, MI 48092
Phone (586) 743-0944

Interoperability endpoints

  • Direct secure messaging: vpanthangi1143798@direct.hfhs.org
  • FHIR API: https://fhir-myrecord.cerner.com/r4/mQjCqHb5rkr1u1foU4dqhQPBpi7Qk9R4/

Organizations & group practices 8

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 6

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": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332720000000",
    "number": "1467571463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21099 MASONIC BLVD",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480821045",
            "telephone_number": "586-296-6213",
            "fax_number": "586-296-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21099 MASONIC BLVD",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480821045",
            "telephone_number": "586-296-6213",
            "fax_number": "586-286-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTHANGI",
        "first_name": "VEENA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2012-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301081639",
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "MI",
            "license": "4301081639",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5186442",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN PHYSICIAN LICENS",
            "identifier": "VP081639",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM GROUP NUMBER",
            "identifier": "700E011730",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "700E031610",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.