Shalini Koppisetty, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301504842 Issued in MI

Practice address

3001 Hospital Dr FL 5
Cheverly, MD 20785-1189

Phone

(301) 618-3772

Fax

(301) 618-2986

NPI assigned

Mar 30, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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 1

Specialty

Internal Medicine

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vituity - Michigan Hospitalists PCGroup PAC ID 2365860996, 76 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230
• University of Michigan Health- Sparrow Clinton Hospital, Saint Johns, MI, CCN 231326
• University of Michigan Health - Sparrow Eaton Hospital, Charlotte, MI, CCN 231327

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: skoppisetty1135079@direct.hfhs.org

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.

• Vituity - Michigan Hospitalists PC

  • Hospitalist Physician
  • Lansing, MI
  • NPI 1487278156

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Edward W. Sparrow Hospital Association

  • Pediatrics Physician
  • Lansing, MI
  • NPI 1831139088
  Medicare reassignment
• Sparrow Specialty Hospital

  • Long Term Care Hospital
  • Lansing, MI
  • NPI 1437655842
  Medicare reassignment
• Edward W Sparrow Hospital Association

  • General Acute Care Hospital
  • Lansing, MI
  • NPI 1073588711
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Edward W Sparrow Hospital Association

  • General Acute Care Hospital
  • Lansing, MI
  • NPI 1073588711
  Care Compare affiliation
• Edward W Sparrow Hospital Association

  • General Acute Care Hospital
  • Lansing, MI
  • NPI 1760710719
  Care Compare affiliation
• Sparrow Clinton Hospital

  • Critical Access Hospital
  • Saint Johns, MI
  • NPI 1093809824
  Care Compare affiliation
• Sparrow Eaton Hospital

  • Orthopaedic Surgery Physician
  • Charlotte, MI
  • NPI 1043419427

  Hospital

  Care Compare affiliation
• Sparrow Eaton Hospital

  • Ambulance
  • Charlotte, MI
  • NPI 1093742249

  Hospital

  Care Compare affiliation
• Sparrow Eaton Hospital

  • Critical Access Hospital
  • Charlotte, MI
  • NPI 1942254529
  Care Compare affiliation

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

{
    "created_epoch": "1522368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1497250401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 HOSPITAL DR FL 5",
            "city": "CHEVERLY",
            "state": "MD",
            "postal_code": "207851189",
            "telephone_number": "301-618-3772",
            "fax_number": "301-618-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 HOSPITAL DR FL 5",
            "city": "CHEVERLY",
            "state": "MD",
            "postal_code": "207851189",
            "telephone_number": "301-618-3772",
            "fax_number": "301-618-2986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPPISETTY",
        "first_name": "SHALINI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-30",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301504842",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kolawole Adeshina Kataye, PHARMD
• Jagroop Singh Khaira
• Monica King, PA-C
• Alexa Kleiman, CRNA
• Richard Yaw Koduah, M.D
• Rex Korden, PA-C
• Fatu Koroma, NP
• Jagdesh Kumar II, MD
• Sammua Nseke Kungaba
• Hareesh Lal, M.D

• Internal Medicine Physician in Cheverly, MD
• Providers in Cheverly, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.