Individual provider Active NPI

Jahnavi Thummaluru

  • Internal Medicine Physician
  • Pontiac, MI
National Provider Identifier
1497137251
Registry record updated Oct 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301107378 Issued in MI
Practice address
44405 Woodward Ave # H-23
Pontiac, MI 48341-5023
Phone
(248) 858-6233
NPI assigned
Jun 29, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301107378 MI Primary

Addresses

Primary practice location

44405 Woodward Ave # H-23
Pontiac, MI 48341-5023

Mailing address

1675 Bloomfield Place Dr 511
Bloomfield Hills, MI 48302-0884
Phone (248) 480-6095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190905001277 SC Practitioner - Internal Medicine 0446569735 Reassigns benefits to 1 organization
I20241125003361 TX Practitioner - Internal Medicine 0446569735 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ipc Healthcare Services of Texas PLLCGroup PAC ID 3971824939, 184 clinicians

Practice addresses (Care Compare)

919 E 32ND St
Austin, TX 78705-2703
Phone (512) 544-4472

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ipc Healthcare Services of Texas, PLLC Internal Medicine CurrentSince Oct 1, 2024 Accepting new patients
Lonestar Pat Associates PA Internal Medicine CurrentSince Oct 1, 2024 Accepting new patients
Southeastern Hospitalist Services PC Internal Medicine CurrentSince Aug 1, 2019 Accepting new patients
St. David's Healthcare Partnership, L.P., LLP Past Accepting new patients
Grand Strand Regional Medical Center LLC Past Accepting new patients

Locations

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

919 E 32nd St
Austin, TX 78705
Phone (512) 343-2466

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

901 W Ben White Blvd
Austin, TX 78704
Phone (512) 342-2382

2000 Scenic Dr
Georgetown, TX 78626
Phone (512) 863-2117

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1435536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445817600000",
    "number": "1497137251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 BLOOMFIELD PLACE DR 511",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020884",
            "telephone_number": "248-480-6095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44405 WOODWARD AVE # H-23",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415023",
            "telephone_number": "248-858-6233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THUMMALURU",
        "first_name": "JAHNAVI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-29",
        "last_updated": "2015-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301107378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.