Individual provider Active NPI

Shalini Thoutreddy, MD

  • Hematology & Oncology Physician
  • Lapeer, MI
National Provider Identifier
1831197581
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
4301080565 Issued in MI
Practice address
1295 Barry Dr Ste B
Lapeer, MI 48446-1369
Phone
(810) 667-4994
NPI assigned
Jul 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 4301080565 MI Primary

Addresses

Primary practice location

1295 Barry Dr Ste B
Lapeer, MI 48446-1369

Mailing address

1295 Barry Dr Ste B
Lapeer, MI 48446-1369
Phone (810) 667-4994

Other identifiers 3

IdentifierTypeStateIssuer
200000026973OtherMIPHYSICIANS HEALTH PLAN
1103307661OtherMIBLUE CROSS BLUE SHIELD OF MICHIGAN/BLUE CARE NETWORK
7470740OtherMIAETNA

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
I20050812000633 MI Practitioner - Hematology/OncologyPractitioner - Internal MedicinePractitioner - Medical Oncology 6507896222 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren OaklandGroup PAC ID 0547173213, 51 clinicians

Practice addresses (Care Compare)

1295 Barry Dr
Suite B
Lapeer, MI 48446-1369
Phone (810) 667-4994

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301080565MIMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital CurrentSince Feb 1, 2011 Accepting new patients
Memorial Hospital Internal Medicine Current Accepting new patients
Memorial Hospital Hematology & Oncology CurrentSince Feb 1, 2011 Accepting new patients

Locations

9000 Peet Rd
Chesaning, MI 48616
Phone (989) 720-2273

826 W King St
Owosso, MI 48867
Phone (989) 720-2273

3337 Britton Rd
Perry, MI 48872
Phone (517) 625-3004

Organizations & group practices 4

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 4

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1831197581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1295 BARRY DR STE B",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484461369",
            "telephone_number": "810-667-4994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1295 BARRY DR STE B",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484461369",
            "telephone_number": "810-667-4994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOUTREDDY",
        "first_name": "SHALINI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MI",
            "license": "4301080565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIANS HEALTH PLAN",
            "identifier": "200000026973",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MICHIGAN/BLUE CARE NETWORK",
            "identifier": "1103307661",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7470740",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lapeer, MI

Sources for this page

Verify at the official NPI Registry.