Individual provider Active NPI

Lalitha Rudraiah, MD

  • Cardiovascular Disease Physician
  • Clinton Township, MI
National Provider Identifier
1619072055
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
4301076745 Issued in MI
Practice address
15500 19 Mile Rd Ste 360
Clinton Township, MI 48038-6331
Phone
(586) 649-9009
Fax
(586) 690-8632
NPI assigned
Sep 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 4301076745 MI Primary

Addresses

Primary practice location

15500 19 Mile Rd Ste 360
Clinton Township, MI 48038-6331

Mailing address

2689 Solution Center
Chicago, IL 60677-3848
Phone (586) 329-1880

Other practice location 1

133 S Main St
Mount Clemens, MI 48043-2308
Phone (586) 468-1600

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lrudraiah252383@direct.hfhs.org

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
I20070111000127 MI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 3072513381 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Macomb Hospital Corporation CurrentSince Jan 1, 2016 Accepting new patients
Henry Ford Health System CurrentSince Dec 1, 2021 Accepting new patients
Henry Ford Health System Current Accepting new patients
Henry Ford Health System Cardiovascular Disease CurrentSince Dec 1, 2021 Accepting new patients
Henry Ford Health Macomb Oakland Hospital Cardiovascular Disease Current Accepting new patients
Henry Ford Health Macomb-Oakland Hospital Cardiovascular Disease CurrentSince Jun 19, 2010 Accepting new patients
Henry Ford Macomb Hospital Corporation CurrentSince Jan 1, 2016 Accepting new patients
Henry Ford Health Macomb-Oakland Hospital CurrentSince Jun 19, 2010 Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients
University Physician Group Past Accepting new patients

Locations

2689 Solution Ctr
Chicago, IL 60677

15717 15 Mile Rd
Clinton Twp, MI 48035
Phone (586) 285-3800

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

15500 19 Mile Rd
Ste 360
Clinton Twp, MI 48038
Phone (313) 286-8840

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

27351 Dequindre Rd
Madison Hts, MI 48071
Phone (248) 967-7000

133 S Main St
Mount Clemens, MI 48043
Phone (586) 329-1880

25195 Kelly Rd
Ste A
Roseville, MI 48066
Phone (586) 775-4594

49050 Schoenherr Rd
Ste 100
Shelby Township, MI 48315
Phone (586) 532-8700

3500 15 Mile Rd
Sterling Hts, MI 48310
Phone (586) 977-9300

11800 E 12 Mile Rd
Warren, MI 48093
Phone (586) 573-5000

6773 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 661-6100

Interoperability endpoints

  • Direct secure messaging: lrudraiah252383@direct.hfhs.org

Organizations & group practices 10

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 7

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1619072055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2689 SOLUTION CENTER",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606773848",
            "telephone_number": "586-329-1880",
            "fax_number": "586-231-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15500 19 MILE RD STE 360",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480386331",
            "telephone_number": "586-649-9009",
            "fax_number": "586-690-8632"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "133 S Main St",
            "address_purpose": "LOCATION",
            "city": "Mount Clemens",
            "state": "MI",
            "postal_code": "480432308",
            "country_code": "US",
            "telephone_number": "586-468-1600",
            "fax_number": "586-465-0329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUDRAIAH",
        "first_name": "LALITHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301076745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lrudraiah252383@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "133 S Main St",
            "city": "Mount Clemens",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480432308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

Verify at the official NPI Registry.