Praveena Koneru, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

4301076287 Issued in MI

Practice address

16407 Southfield Rd
Allen Park, MI 48101

Phone

(313) 271-3000

Fax

(313) 271-3003

NPI assigned

Jul 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AJFBBA
• Direct secure messaging: pkoneru60606@direct.hfhs.org

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.

• Nephrology Hypertension Clinic, PC

  • Nephrology Physician
  • Allen Park, MI
  • NPI 1053466094
  Medicare reassignment NPD
• Nephrology Hypertension Clinic PC

  • Nephrology Physician
  • Allen Park, MI
  • NPI 1225103740
  NPD (past)

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548806400000",
    "number": "1689696106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 77000 DEPT 771255 DEPT 771255",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482771255",
            "telephone_number": "313-271-3000",
            "fax_number": "313-271-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16407 SOUTHFIELD RD",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "48101",
            "telephone_number": "313-271-3000",
            "fax_number": "313-271-3003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14752 Northline Rd",
            "address_purpose": "LOCATION",
            "city": "Southgate",
            "state": "MI",
            "postal_code": "481952698",
            "country_code": "US",
            "telephone_number": "734-285-5030",
            "fax_number": "734-285-8223",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16407 Southfield Rd",
            "address_purpose": "LOCATION",
            "city": "Allen Park",
            "state": "MI",
            "postal_code": "48101",
            "country_code": "US",
            "telephone_number": "313-271-3000",
            "fax_number": "313-271-3003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KONERU",
        "first_name": "PRAVEENA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2019-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "4301076287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shahwar Khan, MD
• Ashlee Kilbourne
• Jenna M Kleiber, PA-C
• Kimberly A Kleinlein
• Dean Kleinschmidt, ATC
• Jane Kramar, M.D.
• Theresa Marie Kramer
• Andrew Peter Kronk, PH.D.
• M. Redwan Kubaisi, MD
• Jennifer Laduke

• Nephrology Physician in Allen Park, MI
• Providers in Allen Park, MI by specialty
• Nephrology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.