Individual provider Active NPI

Ujwala Koduru, MD

  • Internal Medicine Physician
  • Lansing, MI
National Provider Identifier
1700290806
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301104584 Issued in MI
Practice address
2900 Collins Rd
Lansing, MI 48910-8394
Phone
(517) 975-6000
NPI assigned
Jun 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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 4301104584 MI Primary

Addresses

Primary practice location

2900 Collins Rd
Lansing, MI 48910-8394

Mailing address

2900 Collins Rd
Lansing, MI 48910-8394
Phone (517) 975-6000

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
I20180215002406 MI Practitioner - Hematology/OncologyPractitioner - HospitalistPractitioner - Internal Medicine 6507177243 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Bay RegionGroup PAC ID 5597659011, 110 clinicians

Practice addresses (Care Compare)

1900 Columbus Ave
Bay Regional
Bay City, MI 48708-6831
Phone (989) 894-3278

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Bay Region CurrentSince Apr 1, 2019 Accepting new patients
McLaren Bay Region Internal Medicine CurrentSince Apr 1, 2019 Accepting new patients
Apogee Medical Group, Michigan, PC Internal Medicine CurrentSince Dec 18, 2017 Accepting new patients

Locations

1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000

2940 Health Pkwy
Mt Pleasant, MI 48858
Phone (989) 466-2877

Interoperability endpoints

  • Direct secure messaging: ukoduru1134971@direct.hfhs.org

Organizations & group practices 4

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 2

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": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1700290806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 COLLINS RD",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489108394",
            "telephone_number": "517-975-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 COLLINS RD",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489108394",
            "telephone_number": "517-975-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODURU",
        "first_name": "UJWALA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-17",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301104584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.