Active NPI
Nikhil Yedulla
- Student in an Organized Health Care Education/Training Program
- Rochester Hills, MI
National Provider Identifier
1730837402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 125.087726
- Practice address
- 3479 Lincolnshire CT
Rochester Hills, MI 48309-4526 - Phone
- (248) 269-3018
- NPI assigned
- Mar 12, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 125.087726 | IL | Primary |
Addresses
Primary practice location
3479 Lincolnshire CT
Rochester Hills, MI 48309-4526
Mailing address
540 E Canfield St
Detroit, MI 48201-1928
Phone (248) 269-3018
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230525003307 | TN | Order and Referring Only - Orthopedic Surgery | 6709242282 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125.087726 | IL | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779148800000",
"number": "1730837402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "540 E CANFIELD ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482011928",
"telephone_number": "248-269-3018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3479 LINCOLNSHIRE CT",
"city": "ROCHESTER HILLS",
"state": "MI",
"postal_code": "483094526",
"telephone_number": "248-269-3018"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YEDULLA",
"first_name": "NIKHIL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-03-12",
"last_updated": "2026-05-19",
"certification_date": "2026-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "IL",
"license": "125.087726",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.