Active NPI
Parvathi Sivaramakrishnan, M.D.
- Pediatrics Physician
- Waterford, MI
National Provider Identifier
1790872711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 4301066648
- Practice address
- 2561 Elizabeth Lake Rd
Waterford, MI 48328-3313 - Phone
- (248) 682-3300
- Fax
- (248) 682-0026
- NPI assigned
- Oct 10, 2006
- Last updated
- Aug 5, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 4301066648 | MI | Primary |
Addresses
Primary practice location
2561 Elizabeth Lake Rd
Waterford, MI 48328-3313
Mailing address
1455 Lochridge Rd
Bloomfield Township, MI 48302-0734
Phone (248) 682-3300
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17545 | Other | MI | MCARE |
| 6U4828 | Other | MI | HAP |
| O1003206 | Other | MI | HEALTH PLUS |
| 4817959 | Medicaid | MI | |
| 153996 | Other | MI | GREAT LAKES HEALTH PLAN |
| 3506354231 | Other | MI | BCBSM |
| 37975 | Other | MI | HEALTH PLAN OF MICHIGAN |
| 142662 | Other | MI | CARE CHOICES |
| 4817930 | Medicaid | MI |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301066648 | MI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Devyani Khambete, M.D.,P.C. | Pediatrics | 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.
-
- Pediatrics Physician
- Waterford, MI
- NPI 1114136462
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596585600000",
"number": "1790872711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1455 LOCHRIDGE RD",
"city": "BLOOMFIELD TOWNSHIP",
"state": "MI",
"postal_code": "483020734",
"telephone_number": "248-682-3300",
"fax_number": "348-682-0026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2561 ELIZABETH LAKE RD",
"city": "WATERFORD",
"state": "MI",
"postal_code": "483283313",
"telephone_number": "248-682-3300",
"fax_number": "248-682-0026"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIVARAMAKRISHNAN",
"first_name": "PARVATHI",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-10",
"last_updated": "2020-08-05",
"certification_date": "2020-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "4301066648",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MCARE",
"identifier": "17545",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HAP",
"identifier": "6U4828",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PLUS",
"identifier": "O1003206",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4817959",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GREAT LAKES HEALTH PLAN",
"identifier": "153996",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM",
"identifier": "3506354231",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PLAN OF MICHIGAN",
"identifier": "37975",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARE CHOICES",
"identifier": "142662",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4817930",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Waterford, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.