NPIMap

Individual provider Active NPI

Malini Venkatram, MD .

  • Rheumatology Physician
  • Detroit, MI
National Provider Identifier
1467639948
Registry record updated Nov 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
4301085459 Issued in MI
Practice address
4160 John R St
Ste 917
Detroit, MI 48201-2020
Phone
(313) 745-4525
Fax
(313) 745-0011
NPI assigned
Jan 27, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301085459 MI
Rheumatology Physician 207RR0500X 4301085459 MI Primary

Addresses

Primary practice location

4160 John R St
Ste 917
Detroit, MI 48201-2020

Mailing address

1420 Stephenson Hwy
Suite 400-Credentialing
Troy, MI 48083-1189
Phone (248) 581-5972

Other identifiers 4

IdentifierTypeStateIssuer
1346398971OtherMIGRP NPI
11-0F3636-0OtherMIBCBSM GRP PIN
205485614OtherMITAX ID
5357970MedicaidMI

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
I20080903000512 MI Practitioner - RheumatologyPractitioner - Internal Medicine 0143396838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mymichigan Medical Center AlmaGroup PAC ID 3375451404, 140 clinicians

Practice addresses (Care Compare)

4851 E Pickard St
Suite 2400
Mount Pleasant, MI 48858-2042
Phone (989) 488-6355

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Alma Internal Medicine CurrentSince Mar 15, 2023 Accepting new patients
Mymichigan Medical Center Alma Current Accepting new patients
Mymichigan Medical Center Alma Internal Medicine CurrentSince Mar 15, 2023 Accepting new patients
University Physician Group Internal Medicine Past Accepting new patients
Academic Internal Medicine Specialists PLLC Internal Medicine PastSince Jul 1, 2010 Accepting new patients
Mymichigan Medical Center Alma Past Accepting new patients

Locations

315 E Warwick Dr
Ste C
Alma, MI 48801
Phone (989) 463-9300

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

4851 E Pickard St
Ste 2400
Mt Pleasant, MI 48858
Phone (855) 298-9888

Interoperability endpoints

  • Direct secure messaging: mvenkatram393255@direct.hfhs.org
  • Direct secure messaging: mvenkatram136485@mymichiganhealth.midirect.net

Organizations & group practices 6

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": "1201392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383868800000",
    "number": "1467639948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 STEPHENSON HWY",
            "address_2": "SUITE 400-CREDENTIALING",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831189",
            "telephone_number": "248-581-5972",
            "fax_number": "248-581-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 JOHN R ST",
            "address_2": "STE 917",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012020",
            "telephone_number": "313-745-4525",
            "fax_number": "313-745-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENKATRAM",
        "first_name": "MALINI",
        "credential": "MD .",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-27",
        "last_updated": "2013-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301085459",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MI",
            "license": "4301085459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GRP NPI",
            "identifier": "1346398971",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM GRP PIN",
            "identifier": "11-0F3636-0",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "205485614",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5357970",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.