NPIMap

Individual provider Active NPI

Ashwini Mugulvaly Shadakshari, M. D

  • Rheumatology Physician
  • Farmington Hills, MI
National Provider Identifier
1669620233
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
4301097681 Issued in MI
Practice address
28100 Grand River Ave Ste 314
Farmington Hills, MI 48336-5970
Phone
(248) 471-1549
NPI assigned
Sep 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 4301097681 MI Primary

Addresses

Primary practice location

28100 Grand River Ave Ste 314
Farmington Hills, MI 48336-5970

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Phone (947) 522-1865

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ashadakshari96415@direct.beaumont.edu

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
I20110228000841 MI Practitioner - RheumatologyPractitioner - Internal Medicine 8820279557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Beaumont Medical Group- Specialty ServicesGroup PAC ID 7214299866, 868 clinicians

Practice addresses (Care Compare)

28050 Grand River Ave
Farmington Hills, MI 48336-5919
Phone (947) 521-8000

28100 Grand River Ave
Farmington Hills, MI 48336-5970

Hospital & facility affiliations

  • Beaumont Hospital - Farmington Hills Hospital, Farmington Hills, MI, CCN 230151
  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
  • Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020
  • Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Beaumont Medical Group- Specialty Services CurrentSince Oct 1, 2018 Accepting new patients
Metro Diagnostic Imaging, PLLC Internal Medicine CurrentSince Jan 19, 2021 Accepting new patients
Botsford General Hospital Past Accepting new patients

Locations

28100 Grand River Ave
Ste 314
Farmington Hills, MI 48336
Phone (248) 471-1549

28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

8244 Metropolitan Pkwy
Ste B
Sterling Heights, MI 48312
Phone (586) 795-4060

Interoperability endpoints

  • Direct secure messaging: ashadakshari96415@direct.beaumont.edu
  • Direct secure messaging: ashadakshari1255340@epic00.shdirect.org

Organizations & group practices 3

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1669620233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28100 GRAND RIVER AVE STE 314",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483365970",
            "telephone_number": "248-471-1549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADAKSHARI",
        "first_name": "ASHWINI",
        "middle_name": "MUGULVALY",
        "name_prefix": "Dr.",
        "credential": "M. D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-08",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MI",
            "license": "4301097681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ashadakshari96415@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "28100 Grand River Ave Ste 314",
            "city": "Farmington Hills",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483365970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.