NPIMap

Individual provider Active NPI

Srinivas Rao Gatla, M.D

  • Internal Medicine Physician
  • Livonia, MI
National Provider Identifier
1679885388
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301097208 Issued in MI
Practice address
36123 Schoolcraft Rd
Livonia, MI 48150-1216
Phone
(734) 464-0887
Fax
(734) 402-0254
NPI assigned
Jul 10, 2010
Last updated
Jan 21, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301097208 MI Primary

Addresses

Primary practice location

36123 Schoolcraft Rd
Livonia, MI 48150-1216

Mailing address

36123 Schoolcraft Rd
Livonia, MI 48150-1216
Phone (734) 464-0887

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
I20140721000541 MI Practitioner - Internal Medicine 3173749553 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Downriver Internists,P.C.Group PAC ID 5597719468, 4 clinicians

Practice addresses (Care Compare)

21801 Goddard Rd
Taylor, MI 48180-4213
Phone (734) 287-3830

32320 Michigan Ave
Wayne, MI 48184-1423
Phone (734) 641-3630

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301097208MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Downriver Internists,P.C. Internal Medicine CurrentSince Aug 17, 2015 Accepting new patients
Apogee Medical Group, Michigan, PC Internal Medicine CurrentSince Feb 1, 2017 Accepting new patients
Sound Inpatient Physicians-Michigan, PLLC Internal Medicine CurrentSince Nov 4, 2017 Accepting new patients
Sound Inpatient Physicians - Michigan, PLLC Internal Medicine CurrentSince Nov 4, 2017 Accepting new patients
Park Nursing Center of Taylor, LLC Past Accepting new patients
Oakwood Healthcare, Inc. Past Accepting new patients
Oakwood Healthcare, Inc. Past Accepting new patients
Oakwood Healthcare, Inc. Past Accepting new patients
Oakwood Healthcare, Inc. Past Accepting new patients
Henry Ford Wyandotte Hospital Past Accepting new patients

Locations

1521 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5165

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

13801 W 9 Mile Rd
Oak Park, MI 48237
Phone (248) 547-3535

800 S Washington Ave
Saginaw, MI 48601
Phone (989) 776-8000

21801 Goddard Rd
Taylor, MI 48180
Phone (734) 287-3830

Interoperability endpoints

  • Direct secure messaging: sgatla1234699@epic00.shdirect.org
  • Direct secure messaging: sgatla501121@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1278720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1679885388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36123 SCHOOLCRAFT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501216",
            "telephone_number": "734-464-0887",
            "fax_number": "734-402-0254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36123 SCHOOLCRAFT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501216",
            "telephone_number": "734-464-0887",
            "fax_number": "734-402-0254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATLA",
        "first_name": "SRINIVAS",
        "middle_name": "RAO",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-10",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301097208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.