Samyuktha Rani Madishetty MD PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301080548 Issued in MI

Legal business name

SAMYUKTHA RANI MADISHETTY MD PC

Practice address

24100 Oxford St
Dearborn, MI 48124

Phone

(313) 561-3000

Fax

(313) 561-4831

NPI assigned

May 7, 2007

Organization subpart

No

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

Authorized official

Name

Samyuktha Rani Madishetty, MDNPI 1770650889

Title

Owner

Phone

(313) 561-3000

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 2

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

• Samyuktha R Madishetty I, M.D.

  • Internal Medicine Physician
  • Dearborn, MI
  • NPI 1770650889
  Medicare reassignment NPD Authorized official
• Satish N. Kamath, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Dearborn, MI
  • NPI 1093712804
  NPD (past)

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607644800000",
    "number": "1487867644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24100 OXFORD ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242481",
            "telephone_number": "313-561-3000",
            "fax_number": "313-561-4831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24100 OXFORD ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "48124",
            "telephone_number": "313-561-3000",
            "fax_number": "313-561-4831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMYUKTHA RANI MADISHETTY MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A",
        "authorized_official_last_name": "MADISHETTY",
        "authorized_official_first_name": "SAMYUKTHA",
        "authorized_official_middle_name": "RANI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-561-3000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301080548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "110H237950",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN GROUP",
            "identifier": "110H237950",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "DH0704",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487867644",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP",
            "identifier": "I46399",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Reema Sammour
• Tassia Samona, M.D.
• Mekayla Samuels
• Esmeralda Sanabria
• Megan Nicole Sanborn, CRNA
• Katherine Sanchez, DO
• Thea Sanchez
• Kendra Renee Sanders

• Internal Medicine Physician in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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.