Individual provider Active NPI

Geetha Krishnamoorthy, MD

  • Internal Medicine Physician
  • Pontiac, MI
National Provider Identifier
1790723625
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301062031 Issued in MI
Practice address
44428 Woodward Ave Ste 102
Pontiac, MI 48341-5009
Phone
(248) 858-3126
Fax
(248) 858-6499
NPI assigned
Jun 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301062031 MI Primary

Addresses

Primary practice location

44428 Woodward Ave Ste 102
Pontiac, MI 48341-5009

Mailing address

24 Frank Lloyd Wright Dr # J2000
Ann Arbor, MI 48105-9484
Phone (734) 747-6766

Other practice location 1

28411 Northwestern Hwy
suite # 200
Southfield, MI 48034-5544
Phone (248) 354-4709

Other practice location 2

44405 Woodward Ave
Pontiac, MI 48341-5023
Phone (248) 858-3000

Other identifiers 6

IdentifierTypeStateIssuer
G53324OtherMIHAP ID
110F336360OtherMIBCBSM
1346398971OtherMIGROUP NPI
205485614OtherMITAX ID
3347713MedicaidMI
4301062031OtherMILICENSE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070315000061 MI Practitioner - Internal MedicinePractitioner - Hospitalist 5193828937 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians
Iha Ooma Primary LLCGroup PAC ID 7012316664, 45 clinicians

Practice addresses (Care Compare)

4400 Highland Rd
Waterford, MI 48328-1222
Phone (248) 618-6000

44428 Woodward Ave
102 Trinity Health Henderson Academic Prima
Pontiac, MI 48341-5009
Phone (248) 858-3126

Hospital & facility affiliations

  • Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Service Corporation CurrentSince Jan 9, 2023 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Iha Ooma Primary LLC Internal Medicine CurrentSince Jan 9, 2023 Accepting new patients
Iha Ooma Primary LLC Internal Medicine Current Accepting new patients
Iha Ooma Primary LLC Internal Medicine CurrentSince Jan 9, 2023 Accepting new patients
Iha Health Services Corporation CurrentSince Jan 9, 2023 Accepting new patients
Grace University Medical Group Internal Medicine Past Accepting new patients
John Haapaniemi& Barry Lesser PTR,Haapaniemi Lesser Associated PastSince Oct 29, 2023 Accepting new patients
St Joseph Mercy Hospital-SMHC Past Accepting new patients
Iha Health Services Corporation Past Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

1375 S Lapeer Rd
Ste 210
Lake Orion, MI 48360
Phone (248) 693-5700

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

44405 Woodward Ave
Pontiac, MI 48341
Phone (248) 858-3000

44405 Woodward Ave
#H13
Pontiac, MI 48341
Phone (248) 858-3787

4400 Highland Rd
Waterford, MI 48328
Phone (248) 618-6000

Interoperability endpoints

  • Direct secure messaging: gkrishnamoorthy32448@direct.trinity-health.org

Organizations & group practices 10

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 1

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1790723625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR # J2000",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44428 WOODWARD AVE STE 102",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415009",
            "telephone_number": "248-858-3126",
            "fax_number": "248-858-6499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28411 Northwestern Hwy",
            "address_2": "suite # 200",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480345544",
            "country_code": "US",
            "telephone_number": "248-354-4709",
            "fax_number": "248-354-4807",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44405 Woodward Ave",
            "address_purpose": "LOCATION",
            "city": "Pontiac",
            "state": "MI",
            "postal_code": "483415023",
            "country_code": "US",
            "telephone_number": "248-858-3000",
            "fax_number": "248-858-6499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRISHNAMOORTHY",
        "first_name": "GEETHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301062031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP ID",
            "identifier": "G53324",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "110F336360",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1346398971",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "205485614",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3347713",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4301062031",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.