Individual provider Active NPI

Kamalakar China Nerusu, MD

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1609042183
Registry record updated Mar 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301091023 Issued in MI
Practice address
4201 Saint Antoine St
Ste 5C Uhc
Detroit, MI 48201-2153
Phone
(313) 745-7999
Fax
(313) 966-6400
NPI assigned
May 5, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X L1182701 MI
Internal Medicine Physician 207R00000X 4301091023 MI Primary
Hospitalist Physician 208M00000X 4301091023 MI

Addresses

Primary practice location

4201 Saint Antoine St
Ste 5C Uhc
Detroit, MI 48201-2153

Mailing address

1560 E Maple Road
Suite 400-Credentialing
Troy, MI 48083-1189
Phone (313) 745-7999

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20101203000825 MI Practitioner - HospitalistPractitioner - Internal Medicine 0648467522 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Michigan Hospitalists PLLCGroup PAC ID 6800199621, 7 clinicians
University Physician GroupGroup PAC ID 8628087681, 399 clinicians

Practice addresses (Care Compare)

1217 Kearney St
Suite 2
Port Huron, MI 48060-3571
Phone (810) 990-8302

4201 Saint Antoine St
Detroit, MI 48201-2153
Phone (313) 745-3000

Hospital & facility affiliations

  • McLaren Port Huron Hospital, Port Huron, MI, CCN 230216
  • Harper University Hospital Hospital, Detroit, MI, CCN 230104
  • Detroit Receiving Hospital Hospital, Detroit, MI, CCN 230273
  • Lake Huron Medical Center Hospital, Port Huron, MI, CCN 230031

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L1182701MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Michigan Hospitalists PLLC Internal Medicine CurrentSince Jul 1, 2015 Accepting new patients
University Physician Group CurrentSince Sep 1, 2010 Accepting new patients
University Physician Group Internal Medicine CurrentSince Sep 1, 2010 Accepting new patients
Barbara Ann Karmanos Cancer Hospital Past Accepting new patients
VHS Detroit Receiving Hospital Inc Past Accepting new patients
McLaren Port Huron Past Accepting new patients
Prime Healthcare Services-Port Huron LLC Past Accepting new patients
VHS Harper-Hutzel Hospital Inc Past Accepting new patients

Locations

4201 Saint Antoine St
Ste 5C
Detroit, MI 48201
Phone (313) 577-5030

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

1217 Kearney St
Ste 2
Port Huron, MI 48060
Phone (810) 990-8302

1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200

1560 E Maple Rd
Ste 400
Troy, MI 48083

Interoperability endpoints

  • Direct secure messaging: knerusu@direct.dmc.org

Organizations & group practices 8

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 4

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": "1209945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456790400000",
    "number": "1609042183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 E MAPLE ROAD",
            "address_2": "SUITE 400-CREDENTIALING",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831189",
            "telephone_number": "313-745-7999",
            "fax_number": "313-966-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST",
            "address_2": "STE 5C UHC",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-7999",
            "fax_number": "313-966-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NERUSU",
        "first_name": "KAMALAKAR",
        "middle_name": "CHINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-05",
        "last_updated": "2016-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "L1182701",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301091023",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MI",
            "license": "4301091023",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.