Kempaiah A Gowda, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

4301037654 Issued in MI

Practice address

15150 Fort St
Southgate, MI 48195-1302

Phone

(734) 282-4800

Fax

(734) 282-9302

NPI assigned

May 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 9

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

Specialty

Cardiovascular Disease (Cardiology)Also: Internal Medicine

Education

Other, 1963

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Downriver Heart and Vascular Specialists, PCGroup PAC ID 2062416522, 8 clinicians

Henry Ford Wyandotte HospitalGroup PAC ID 2264334499, shared by 9 NPIs, 194 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wyandotte Hospital and Medical Center Hospital, Wyandotte, MI, CCN 230146

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kgowda59212@direct.hfhs.org

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.

• Downriver Heart and Vascular Specialists PC

  • Interventional Cardiology Physician
  • Southgate, MI
  • NPI 1194838383

  Cardiovascular Disease

  Medicare reassignment Care Compare group NPD
• Henry Ford Wyandotte Hospital

  • Certified Registered Nurse Anesthetist
  • Wyandotte, MI
  • NPI 1386685212
  Medicare reassignment NPD
• Henry Ford Wyandotte Hospital

  • Cardiovascular Disease Physician
  • Wyandotte, MI
  • NPI 1700145851
  Medicare reassignment NPD
• Henry Ford Wyandotte Hospital

  • Community/Retail Pharmacy
  • Brownstown TWP, MI
  • NPI 1356356984
  NPD
• Henry Ford Wyandotte Hospital

  • General Acute Care Hospital
  • Wyandotte, MI
  • NPI 1710205844
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Wyandotte Hospital

  • Ambulatory Surgical Clinic/Center
  • Wyandotte, MI
  • NPI 1093901035

  Hospital

  Care Compare affiliation
• Henry Ford Wyandotte Hospital

  • General Acute Care Hospital
  • Wyandotte, MI
  • NPI 1992725352
  Care Compare affiliation

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490832000000",
    "number": "1730133265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15150 FORT ST",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481951302",
            "telephone_number": "734-282-4800",
            "fax_number": "734-282-9302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15150 FORT ST",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481951302",
            "telephone_number": "734-282-4800",
            "fax_number": "734-282-9302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOWDA",
        "first_name": "KEMPAIAH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2017-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301037654",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301037652",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "4301037652",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TYPE 1 NPI #",
            "identifier": "1730133265",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0608201051",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11277306",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110007760",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDS #",
            "identifier": "4301037652",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP",
            "identifier": "B43075",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "0820105",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1623343",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mikenzi Gooms
• Amanda Gordon
• Brandi Gordon, BCBA
• Latrice Goree
• Lisa Goss, LLPC
• Stephanie Grabowski
• David Jerome Grachek Jr., D.D.S.
• Kasha Annette Graves
• Jeanne Marie Gray, CNP
• Greater Michigan Counseling Center PLLC

• Cardiovascular Disease Physician in Southgate, MI
• Providers in Southgate, MI by specialty
• Cardiovascular Disease Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.