Individual provider Active NPI

Shilpa Kodati, MD

  • Ophthalmology Physician
  • Ann Arbor, MI
National Provider Identifier
1780949545
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
4301507901 Issued in MI
Practice address
1000 Wall St
Ann Arbor, MI 48105-1912
Phone
(734) 764-4190
NPI assigned
Jul 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 252783 MA
Ophthalmology Physician 207W00000X RS2015-0468 NM
Ophthalmology Physician 207W00000X 4301507901 MI Primary

Addresses

Primary practice location

1000 Wall St
Ann Arbor, MI 48105-1912

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other practice location 1

1977 Butler Blvd
Alkek Eye Center, Baylor college of medicine
Houston, TX 77030
Phone (713) 798-5143

Other practice location 2

National Eye Institute National Of Health
Building 10
Bethesda, MD 20892-0001
Phone (617) 949-1558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170711002811 TX Practitioner - Ophthalmology 4486923190 Reassigns benefits to 3 organizations
I20221109000419 MI Practitioner - Ophthalmology 4486923190 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of MichiganGroup PAC ID 3779496856, 3,344 clinicians

Practice addresses (Care Compare)

1000 Wall St
Ann Arbor, MI 48105-1912
Phone (734) 764-4190

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000
Phone (734) 764-4190

7500 Challis Rd
Brighton, MI 48116-9416
Phone (734) 764-4190

Hospital & facility affiliations

  • University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046
  • Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
252783MAMDInternal Medicine Physician
4301507901MIMDOphthalmology Physician
RS2015-0468NMMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Ophthalmology CurrentSince Oct 25, 2022 Accepting new patients
Texas Children'S Physician Group CurrentSince Jul 19, 2017 Accepting new patients
Baylor College of Medicine CurrentSince Jun 17, 2017 Accepting new patients
Baylor College of Medicine Internal Medicine CurrentSince Jun 17, 2017 Accepting new patients
Baylor College of Medicine CurrentSince Jun 17, 2017 Accepting new patients
Regents of the University of Michigan CurrentSince Oct 25, 2022 Accepting new patients
Baylor College of Medicine Internal Medicine CurrentSince Jun 17, 2017 Accepting new patients
Regents of the University of Michigan Past Accepting new patients

Locations

1000 Wall St
Ann Arbor, MI 48105
Phone (734) 763-1415

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

1977 Butler Blvd
Houston, TX 77030
Phone (713) 798-4857

1977 Butler Blvd
Ste E3
Houston, TX 77030

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

2450 Holcombe Blvd
Ste NB34L
Houston, TX 77021
Phone (713) 796-0003

Organizations & group practices 8

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1780949545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WALL ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481051912",
            "telephone_number": "734-764-4190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1977 Butler Blvd",
            "address_2": "Alkek Eye Center, Baylor college of medicine",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "77030",
            "country_code": "US",
            "telephone_number": "713-798-5143",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "National Eye Institute National Of Health",
            "address_2": "Building 10",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "208920001",
            "country_code": "US",
            "telephone_number": "617-949-1558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KODATI",
        "first_name": "SHILPA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-09",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "252783",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NM",
            "license": "RS2015-0468",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301507901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.