NPIMap

Individual provider Active NPI

Bhavana Pabbati Liyanaarachchi, DO

  • Internal Medicine Physician
  • Warren, MI
National Provider Identifier
1548835184
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101028151 Issued in MI
Practice address
11885 E 12 Mile Rd Ste 300a
Warren, MI 48093-3467
Phone
(586) 582-6630
NPI assigned
May 25, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 5101028151 MI
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 5101028151 MI Primary

Addresses

Primary practice location

11885 E 12 Mile Rd Ste 300a
Warren, MI 48093-3467

Mailing address

44190 Deep Hollow Cir
Northville, MI 48168-8414
Phone (303) 330-3630

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
I20240827004306 MI Practitioner - Hospitalist 6002208212 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Michigan State University College of Osteopathic Medicine, 2021
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)

406 E Elm St
Carson City, MI 48811-9693
Phone (989) 584-3131

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101028151MIMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vituity - Michigan Hospitalists PC Internal Medicine CurrentSince Aug 20, 2024 Accepting new patients
Edward W Sparrow Hospital Association Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

406 E Elm St
Carson City, MI 48811
Phone (517) 584-3131

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

1215 E Michigan Ave
#8W
Lansing, MI 48912
Phone (517) 364-2614

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 5

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": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1548835184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44190 DEEP HOLLOW CIR",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481688414",
            "telephone_number": "303-330-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11885 E 12 MILE RD STE 300A",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933467",
            "telephone_number": "586-582-6630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIYANAARACHCHI",
        "first_name": "BHAVANA",
        "middle_name": "PABBATI",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-25",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MI",
            "license": "5101028151",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101028151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.