Shyam S Dandamudi, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301041316 Issued in MI

Practice address

714 S Trumbull
Bay City, MI 48708-4217

Phone

(989) 893-5541

Fax

(989) 893-5543

NPI assigned

Mar 9, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• McLaren Medical Group

  • Family Medicine Physician
  • Lapeer, MI
  • NPI 1346396066

  Internal Medicine, MI

  Medicare reassignment NPD
• McLaren Medical Group

  • Diagnostic Radiology Physician
  • Lapeer, MI
  • NPI 1073650750
  NPD

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355702400000",
    "number": "1801928577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 S TRUMBULL",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487084217",
            "telephone_number": "989-893-5541",
            "fax_number": "989-893-5543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 S TRUMBULL",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487084217",
            "telephone_number": "989-893-5541",
            "fax_number": "989-893-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANDAMUDI",
        "first_name": "SHYAM",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2012-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301041316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101398348",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhonda J Dailey
• Kyle Harrison Dake
• Jennifer Sue Daly, CRNA
• Valerie Daly, LPC
• Rajesh Dandamudi, M.D.
• Daniel G Ankoviak DDS PC
• Daniel Stuart Ruff DDS, PC
• Jacob Michael Daniel
• Taylor Ann Daniel
• Katelynne Darbee

• All providers in Bay City, MI
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.