NPIMap

Individual provider Active NPI

Radhika K Thalla, M.D

  • Nephrology Physician
  • Berkley, MI
National Provider Identifier
1780738047
Registry record updated Sep 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
4301089117 Issued in MI
Practice address
27901 Woodward Ave
Suite #210
Berkley, MI 48072-0919
Phone
(248) 414-5377
NPI assigned
Jan 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301089117 MI
Nephrology Physician 207RN0300X 4301089117 MI Primary

Addresses

Primary practice location

27901 Woodward Ave
Suite #210
Berkley, MI 48072-0919

Mailing address

47652 Adriana CT
Canton, MI 48187-1336
Phone (734) 237-1923

Other names 1

  • Dr. Radhika Katakam Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090924000253 MI Practitioner - Internal MedicinePractitioner - Nephrology 5092861542 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nephrology Consultants PCGroup PAC ID 2668436544, 5 clinicians
Sciometrix LLCGroup PAC ID 7618367087, 58 clinicians

Practice addresses (Care Compare)

27901 Woodward Ave
Suite 210
Berkley, MI 48072-0918
Phone (248) 414-5377

306 S Washington Ave
Suite 600
Royal Oak, MI 48067-3837
Phone (860) 335-5064

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sciometrix LLC CurrentSince Nov 15, 2023 Accepting new patients
Sciometrix Inc CurrentSince Nov 15, 2023 Accepting new patients

Locations

306 S Washington Ave
Ste 600
Royal Oak, MI 48067

Organizations & group practices 3

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252368000000",
    "number": "1780738047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47652 ADRIANA CT",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481871336",
            "telephone_number": "734-237-1923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27901 WOODWARD AVE",
            "address_2": "SUITE #210",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480720919",
            "telephone_number": "248-414-5377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THALLA",
        "first_name": "RADHIKA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2009-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301089117",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "4301089117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RADHIKA",
            "last_name": "KATAKAM",
            "prefix": "DR.",
            "credential": "M.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Berkley, MI

Sources for this page

Verify at the official NPI Registry.