Individual provider Active NPI

Raghuram Sarvepalli, MD

  • Family Medicine Physician
  • Saginaw, MI
National Provider Identifier
1699771261
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
RS065688 Issued in MI
Practice address
3570 Shattuck Rd
Saginaw, MI 48603-3153
Phone
(989) 792-5353
Fax
(989) 792-3033
NPI assigned
Jun 28, 2005
Last updated
Apr 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X RS065688 MI Primary

Addresses

Primary practice location

3570 Shattuck Rd
Saginaw, MI 48603-3153

Mailing address

3570 Shattuck Rd
Saginaw, MI 48603-3153
Phone (989) 792-5353

Other identifiers 1

IdentifierTypeStateIssuer
3372055MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bharmasarvepalli@smomsjhs.allscriptsdirect.net

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
I20101203001268 MI Practitioner - Family Practice 9133316052 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RS065688MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Saginaw Family Medicine Current Accepting new patients
Mymichigan Medical Center Saginaw CurrentSince Jul 1, 1997 Accepting new patients
Mymichigan Medical Center Saginaw Family Medicine CurrentSince Jul 1, 1997 Accepting new patients
Mymichigan Medical Center Saginaw Past Accepting new patients
Mymichigan Medical Center Saginaw Family Medicine Past Accepting new patients

Locations

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

3570 Shattuck Rd
Saginaw, MI 48603
Phone (989) 792-5353

Interoperability endpoints

  • Direct secure messaging: bharmasarvepalli@smomsjhs.allscriptsdirect.net
  • Direct secure messaging: raghu.sarvepalli.1@11016.direct.athenahealth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1699771261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3570 SHATTUCK RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486033153",
            "telephone_number": "989-792-5353",
            "fax_number": "989-792-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3570 SHATTUCK RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486033153",
            "telephone_number": "989-792-5353",
            "fax_number": "989-792-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARVEPALLI",
        "first_name": "RAGHURAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "RS065688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3372055",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bharmasarvepalli@smomsjhs.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "3570 Shattuck Rd",
            "city": "Saginaw",
            "state": "MI",
            "country_code": "US",
            "postal_code": "486033153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

Verify at the official NPI Registry.