NPIMap

Individual provider Active NPI

Srinivas Koneru, MD

  • Cardiovascular Disease Physician
  • Sterling Heights, MI
National Provider Identifier
1477599587
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
4301080674 Issued in MI
Practice address
33376 Dequindre Rd
Sterling Heights, MI 48310-5966
Phone
(586) 722-7440
Fax
(586) 722-7675
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 4301080674 MI Primary

Addresses

Primary practice location

33376 Dequindre Rd
Sterling Heights, MI 48310-5966

Mailing address

33376 Dequindre Rd
Sterling Heights, MI 48310-5966
Phone (586) 722-7440

Other identifiers 11

IdentifierTypeStateIssuer
G58723OtherHAP
136847OtherCARE CHOICES
449652010MedicaidMI
110E014810OtherBCBS
16829OtherMCARE
P00012493OtherPALMETTO
136847OtherPREFERRED CHOICES
144732OtherGREAT LAKES
110E014810OtherBCN
136847OtherCAPE
921607OtherOMNI

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
I20041008001147 MI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Peripheral Vascular Disease 9335108802 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine, Peripheral Vascular Disease
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health Macomb Oakland HospitalGroup PAC ID 7315859725, 155 clinicians
Pioneer Medical Associates PCGroup PAC ID 2860743309, 23 clinicians
K Heart and Vascular Institute PLLCGroup PAC ID 4789943887, 5 clinicians

Practice addresses (Care Compare)

11800 E 12 Mile Rd
Warren, MI 48093-3472
Phone (586) 573-5000

15945 19 Mile Rd
Suite 100
Clinton Township, MI 48038-1147
Phone (586) 286-8677

33376 Dequindre Rd
Sterling Heights, MI 48310-5966
Phone (586) 722-7440

Hospital & facility affiliations

  • Henry Ford Health Warren Hospital Hospital, Warren, MI, CCN 230195
  • Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269
  • Ascension Providence Rochester Hospital Hospital, Rochester, MI, CCN 230254
  • Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting92
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301080674MIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
K Heart & Vascular PLLC Cardiovascular Disease Current Accepting new patients
Macomb Physicians Group, PLLC Cardiovascular Disease CurrentSince Apr 1, 2008 Accepting new patients
Pioneer Medical Associates P.C. Cardiovascular Disease CurrentSince Sep 1, 2018 Accepting new patients
Pioneer Endoscopy & Surgery Center, L.L.C. CurrentSince Sep 1, 2018 Accepting new patients
Henry Ford Health Rochester Hospital Cardiovascular Disease CurrentSince Sep 15, 2018 Accepting new patients
Henry Ford Health Rochester Hospital CurrentSince Sep 15, 2018 Accepting new patients
Paramount Medical Group PC Current Accepting new patients
K Heart & Vascular Institute, PLLC Cardiovascular Disease CurrentSince Mar 1, 2018 Accepting new patients
Metro Diagnostic Imaging, PLLC Cardiovascular Disease CurrentSince Apr 30, 2010 Accepting new patients
Henry Ford Health Macomb Oakland Hospital Past Accepting new patients
Infinity Medical Group, PLLC Past Accepting new patients
Cardiology Consultantsof Westchester, PC Cardiovascular Disease Past Accepting new patients

Locations

15945 19 Mile Rd
Ste 206
Clinton Township, MI 48038
Phone (586) 228-6603

15945 19 Mile Rd
Ste 100
Clinton Twp, MI 48038
Phone (586) 263-0464

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

1101 W University Dr
Rochester Hls, MI 48307
Phone (248) 601-4805

13350 24 Mile Rd
Ste 800
Shelby Township, MI 48315
Phone (586) 722-7440

29111 Harper Ave
St Clr Shores, MI 48081
Phone (586) 771-2097

8244 Metropolitan Pkwy
Ste B
Sterling Heights, MI 48312
Phone (586) 795-4060

8244 Metropolitan Pkwy
Ste C
Sterling Heights, MI 48312
Phone (586) 795-4060

33376 Dequindre Rd
Sterling Hts, MI 48310
Phone (248) 986-3252

11800 E 12 Mile Rd
Warren, MI 48093
Phone (586) 573-5000

13430 E 13 Mile Rd
Warren, MI 48088
Phone (248) 854-8999

11900 E 12 Mile Rd
Ste 103
Warren, MI 48093
Phone (586) 574-0890

27560 Hoover Rd
Warren, MI 48093
Phone (586) 573-5890

11900 E 12 Mile Rd
Ste 100
Warren, MI 48093
Phone (586) 573-5890

27540 Hoover Rd
Warren, MI 48093
Phone (586) 754-3160

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8209/brand/5/csg/21/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/JDIBBA
  • Direct secure messaging: skoneru63378@direct.hfhs.org

Organizations & group practices 13

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.

View all 13

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1477599587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33376 DEQUINDRE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483105966",
            "telephone_number": "586-722-7440",
            "fax_number": "586-722-7675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33376 DEQUINDRE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483105966",
            "telephone_number": "586-722-7440",
            "fax_number": "586-722-7675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONERU",
        "first_name": "SRINIVAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301080674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP",
            "identifier": "G58723",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES",
            "identifier": "136847",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "449652010",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "110E014810",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE",
            "identifier": "16829",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO",
            "identifier": "P00012493",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CHOICES",
            "identifier": "136847",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT LAKES",
            "identifier": "144732",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN",
            "identifier": "110E014810",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPE",
            "identifier": "136847",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OMNI",
            "identifier": "921607",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

Verify at the official NPI Registry.