Individual provider Active NPI

Sruthi Mantri Garimella, MD

  • Student in an Organized Health Care Education/Training Program
  • Ann Arbor, MI
National Provider Identifier
1639969389
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
4351054394 Issued in MI
Practice address
380 Parkland PLZ
Ann Arbor, MI 48103-6201
Phone
(734) 539-5080
NPI assigned
May 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 4351054394 MI Primary

Addresses

Primary practice location

380 Parkland PLZ
Ann Arbor, MI 48103-6201

Mailing address

1540 E Hospital Dr
MPB D3230
Ann Arbor, MI 48109-4000
Phone (734) 539-5080

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
I20250624001259 MI Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 3779095948

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4351054394MIMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1746576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1639969389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 E HOSPITAL DR",
            "address_2": "MPB D3230",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481094000",
            "telephone_number": "734-539-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 PARKLAND PLZ",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481036201",
            "telephone_number": "734-539-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTRI GARIMELLA",
        "first_name": "SRUTHI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-07",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4351054394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.