Individual provider Active NPI

Dheeraj Thammineni, M.D.

  • Hospitalist Physician
  • Shelby Township, MI
National Provider Identifier
1710115969
Registry record updated Sep 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
4301090476 Issued in MI
Practice address
50505 Schoenherr Rd
Suite 340
Shelby Township, MI 48315-3140
Phone
(586) 731-8400
Fax
(586) 731-8406
NPI assigned
Jun 26, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 4301090476 MI Primary
Internal Medicine Physician 207R00000X 4301090476 MI

Addresses

Primary practice location

50505 Schoenherr Rd
Suite 340
Shelby Township, MI 48315-3140

Mailing address

50505 Schoenherr Rd
Suite 340
Shelby Township, MI 48315-3140
Phone (586) 731-8400

Other identifiers 2

IdentifierTypeStateIssuer
0502488OtherMIBCBS
1710115969MedicaidMI

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
I20101112001065 MI Practitioner - Internal Medicine 6406041672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1000 Harrington St
Mount Clemens, MI 48043-2920
Phone (586) 493-8000

Hospital & facility affiliations

  • Alpha Therapeutics, PC Home health agency, Warren, MI, CCN 237721
  • McLaren Macomb Hospital, Mount Clemens, MI, CCN 230227
  • McLaren Port Huron Hospital, Port Huron, MI, CCN 230216

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301090476MIMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Hospitalists Internal Medicine CurrentSince Sep 8, 2022 Accepting new patients
McLaren Macomb Past Accepting new patients

Locations

1000 Harrington St
Mount Clemens, MI 48043
Phone (586) 493-3727

Interoperability endpoints

  • Direct secure messaging: dthammineni63525@direct.hfhs.org

Organizations & group practices 2

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 4

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": "1245974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443484800000",
    "number": "1710115969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50505 SCHOENHERR RD",
            "address_2": "SUITE 340",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483153140",
            "telephone_number": "586-731-8400",
            "fax_number": "586-731-8406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50505 SCHOENHERR RD",
            "address_2": "SUITE 340",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483153140",
            "telephone_number": "586-731-8400",
            "fax_number": "586-731-8406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAMMINENI",
        "first_name": "DHEERAJ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-26",
        "last_updated": "2015-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MI",
            "license": "4301090476",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301090476",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0502488",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710115969",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

Verify at the official NPI Registry.