Individual provider Active NPI

Padmaja Vemuri, M.D.,

  • Family Medicine Physician
  • Dearborn, MI
National Provider Identifier
1770786931
Registry record updated Nov 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301079529 Issued in MI
Practice address
18101 Oakwood Blvd,
Oakwood Hospital and Medical Center
Dearborn, MI 48124
Phone
(313) 982-5203
Fax
(313) 436-2071
NPI assigned
Jun 6, 2007
Last updated
Nov 1, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301079529 MI Primary

Addresses

Primary practice location

18101 Oakwood Blvd,
Oakwood Hospital and Medical Center
Dearborn, MI 48124

Mailing address

24579 Perceval LN
Novi, MI 48375-2355
Phone (248) 347-3171

Other identifiers 2

IdentifierTypeStateIssuer
0828647OtherMIBLUE CROSS PPO
# 4466245-10MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301079529MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genesys Integrated Group Practice PC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1770786931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24579 PERCEVAL LN",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483752355",
            "telephone_number": "248-347-3171",
            "fax_number": "248-347-3171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 OAKWOOD BLVD,",
            "address_2": "OAKWOOD HOSPITAL AND MEDICAL CENTER",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "48124",
            "telephone_number": "313-982-5203",
            "fax_number": "313-436-2071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEMURI",
        "first_name": "PADMAJA",
        "name_prefix": "Dr.",
        "credential": "M.D.,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301079529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PPO",
            "identifier": "0828647",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "# 4466245-10",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.