Active NPI
Vijaya Challa, M.D.P.C.
- Primary Care Clinic/Center
- Dearborn, MI
National Provider Identifier
1629332218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- License
- VC080035
- Legal business name
- VIJAYA CHALLA, M.D.P.C.
- Practice address
- 24604 Michigan Ave Ste 100
Dearborn, MI 48124-1760 - Phone
- (313) 562-9020
- Fax
- (313) 562-8511
- NPI assigned
- Jun 27, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Venky R Challa
- Title
- Office Manager
- Phone
- (313) 562-9020
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | VC080035 | MI | Primary |
Addresses
Primary practice location
24604 Michigan Ave Ste 100
Dearborn, MI 48124-1760
Mailing address
24604 Michigan Ave Ste 100
Dearborn, MI 48124-1760
Phone (313) 562-9020
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4865150 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
24604 Michigan Ave
Ste 100
Dearborn, MI 48124
Phone (313) 388-5540
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Dearborn, MI
- NPI 1528016490
-
- Internal Medicine Physician
- Dearborn, MI
- NPI 1730165085
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340755200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1780876800000",
"number": "1629332218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24604 MICHIGAN AVE STE 100",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481241760",
"telephone_number": "313-562-9020",
"fax_number": "313-562-8511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24604 MICHIGAN AVE STE 100",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481241760",
"telephone_number": "313-562-9020",
"fax_number": "313-562-8511"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VIJAYA CHALLA, M.D.P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2012-06-27",
"last_updated": "2026-06-08",
"certification_date": "2026-06-08",
"status": "A",
"authorized_official_last_name": "CHALLA",
"authorized_official_first_name": "VENKY",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "313-562-9020"
},
"taxonomies": [
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": "MI",
"license": "VC080035",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4865150",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.