Individual provider Active NPI

Nadimpalli V Raju, MD

  • Psychiatry Physician
  • Detroit, MI
National Provider Identifier
1700834827
Registry record updated Nov 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301039665 Issued in MI
Practice address
22101 Moross Rd
Detroit, MI 48236-2148
Phone
(313) 343-3457
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4301039665 MI Primary

Addresses

Primary practice location

22101 Moross Rd
Detroit, MI 48236-2148

Mailing address

6529 Burtonwood Dr
West Bloomfield, MI 48322-3244
Phone (248) 730-0994

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
I20041206000281 MI Practitioner - Psychiatry 3274599832 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southwest Counseling Solutions IncGroup PAC ID 4082648365, 15 clinicians
Neighborhood Service OrganizationGroup PAC ID 7113907387, 11 clinicians

Practice addresses (Care Compare)

1700 Waterman St
Detroit, MI 48209-2022
Phone (313) 841-8900

8600 Woodward Ave
Nso/Life Choices
Detroit, MI 48202-2142
Phone (313) 875-7601

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Counseling Solutions Psychiatry CurrentSince Apr 4, 2016 Accepting new patients
Neighborhood Service Organization CurrentSince Oct 1, 1996 Accepting new patients
Nadimpalli Raju MD PC Psychiatry PastSince Jan 30, 2002 Accepting new patients

Locations

220 Bagley St
Ste 1200
Detroit, MI 48226
Phone (313) 961-7990

5716 Michigan Ave
Detroit, MI 48210
Phone (313) 554-1095

8600 Woodward Ave
Detroit, MI 48202
Phone (313) 875-7601

1700 Waterman St
Detroit, MI 48209
Phone (313) 841-8900

35180 Nankin Blvd
Ste 205
Westland, MI 48185
Phone (313) 875-7601

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383868800000",
    "number": "1700834827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6529 BURTONWOOD DR",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223244",
            "telephone_number": "248-730-0994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22101 MOROSS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362148",
            "telephone_number": "313-343-3457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJU",
        "first_name": "NADIMPALLI",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2013-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301039665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.