NPIMap

Individual provider Active NPI

Alok Shukla, M.D

  • Internal Medicine Physician
  • Roseville, MI
National Provider Identifier
1508948183
Registry record updated Dec 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
045713 Issued in MI
Practice address
25779 Kelly Rd
Roseville, MI 48066-4973
Phone
(586) 777-7772
Fax
(583) 777-6231
NPI assigned
Oct 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2014

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 045713 MI Primary

Addresses

Primary practice location

25779 Kelly Rd
Roseville, MI 48066-4973

Mailing address

25779 Kelly Rd
Roseville, MI 48066-4973
Phone (586) 777-7772

Other identifiers 1

IdentifierTypeStateIssuer
1868687MedicaidMI

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
I20090716000645 MI Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology)Practitioner - Addiction Medicine 4789736042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Addiction Medicine, Cardiovascular Disease (Cardiology)
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Complete Care Rehab LLCGroup PAC ID 2466423637, 12 clinicians

Practice addresses (Care Compare)

25779 Kelly Rd
Roseville, MI 48066-4973

31370 Harper Ave
Saint Clair Shores, MI 48082-2450

Hospital & facility affiliations

  • Residential Home Health Home health agency, Troy, MI, CCN 237459
  • Platinum Care Home Services, Inc Home health agency, Warren, MI, CCN 237528
  • Beaumont Home Health Home health agency, Troy, MI, CCN 237112
  • Beaumont Hospital - Grosse Pointe Hospital, Grosse Pointe, MI, CCN 230089
  • Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165
  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
  • Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
045713MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alok Shukla Enterprises PC Internal Medicine CurrentSince Apr 30, 2003 Accepting new patients
William Beaumont Hospital Past Accepting new patients
Henry Ford Health St. John Hospital Past Accepting new patients

Locations

25779 Kelly Rd
Roseville, MI 48066
Phone (586) 774-7987

24025 Mack Ave
St Clr Shores, MI 48080
Phone (586) 777-7772

Interoperability endpoints

  • Direct secure messaging: ashukla1151254@direct.hfhs.org

Organizations & group practices 4

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 8

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418688000000",
    "number": "1508948183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25779 KELLY RD",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664973",
            "telephone_number": "586-777-7772",
            "fax_number": "583-777-6231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25779 KELLY RD",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664973",
            "telephone_number": "586-777-7772",
            "fax_number": "583-777-6231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUKLA",
        "first_name": "ALOK",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2014-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "045713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1868687",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MI

Sources for this page

Verify at the official NPI Registry.