Active NPI
Sambasiva Kottamasu, M.D.
- Diagnostic Radiology Physician
- Saginaw, MI
National Provider Identifier
1699745265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 4301033432
- Practice address
- 3400 N Center Rd
Suite 400
Saginaw, MI 48603-7920 - Phone
- (989) 799-5600
- NPI assigned
- Jan 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 4301033432 | MI | Primary |
Addresses
Primary practice location
3400 N Center Rd
Suite 400
Saginaw, MI 48603-7920
Mailing address
3400 N Center Rd
Suite 400
Saginaw, MI 48603-7920
Phone (989) 799-5600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4345929 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301033432 | MI | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midmichigan Regional Imaging | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Magnetic Resonance Imaging (MRI) Clinic/Center
- Auburn, MI
- NPI 1235182932
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275609600000",
"number": "1699745265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 N CENTER RD",
"address_2": "SUITE 400",
"city": "SAGINAW",
"state": "MI",
"postal_code": "486037920",
"telephone_number": "989-799-5600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 N CENTER RD",
"address_2": "SUITE 400",
"city": "SAGINAW",
"state": "MI",
"postal_code": "486037920",
"telephone_number": "989-799-5600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOTTAMASU",
"first_name": "SAMBASIVA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-25",
"last_updated": "2010-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MI",
"license": "4301033432",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4345929",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saginaw, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.