Southwest Michigan Plastic and Hand Surgery, PC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

SOUTHWEST MICHIGAN PLASTIC AND HAND SURGERY, PC

Practice address

7971 Moorsbridge Rd
Portage, MI 49024-4075

Phone

(269) 329-2900

Fax

(269) 329-1408

NPI assigned

Oct 6, 2016

Organization subpart

No

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

Authorized official

Name

Raghu Elluru

Title

MD

Phone

(269) 273-9789

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Raghuram Gop Elluru, M.D., F.A.C.S.

  • Plastic and Reconstructive Surgery Physician
  • Portage, MI
  • NPI 1629075668

  Plastic Surgery

  Medicare reassignment NPD

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

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481760000000",
    "number": "1720538341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7971 MOORSBRIDGE RD",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244075",
            "telephone_number": "269-329-2900",
            "fax_number": "269-329-1408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7971 MOORSBRIDGE RD",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244075",
            "telephone_number": "269-329-2900",
            "fax_number": "269-329-1408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST MICHIGAN PLASTIC AND HAND SURGERY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-06",
        "last_updated": "2016-12-15",
        "status": "A",
        "authorized_official_last_name": "ELLURU",
        "authorized_official_first_name": "RAGHU",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "269-273-9789"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nicole Spagnuolo
• Karen A Spaude
• Justice Nicole Spearritt, LMSW
• Shadrack E Spears, PTA

• Plastic Surgery Physician in Portage, MI
• Providers in Portage, MI by specialty
• Plastic Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.