Individual provider Active NPI

Vatsala Katragadda, MD

  • Internal Medicine Physician
  • Dearborn, MI
National Provider Identifier
1841270634
Registry record updated Jul 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301066984 Issued in MI
Practice address
861 Monroe Street
Dearborn, MI 48124
Phone
(313) 274-1800
Fax
(313) 274-8717
NPI assigned
Jan 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301066984 MI Primary
Specialist 174400000X 4301066984 MI

Addresses

Primary practice location

861 Monroe Street
Dearborn, MI 48124

Mailing address

861 Monroe Street
Dearborn, MI 48124-2308
Phone (313) 274-0774

Other identifiers 1

IdentifierTypeStateIssuer
104623258MedicaidMI

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
I20041101000925 MI Practitioner - Hematology/Oncology 4587626601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren FlintGroup PAC ID 8628975497, 144 clinicians

Practice addresses (Care Compare)

4100 Beecher Rd
Suite B
Flint, MI 48532-3661
Phone (810) 235-8568

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Methodist Hospitals, Inc Hematology & Oncology CurrentSince Sep 20, 2022 Accepting new patients
McLaren Flint Internal Medicine CurrentSince Sep 1, 2024 Accepting new patients
The Methodist Hospitals, Inc CurrentSince Sep 20, 2022 Accepting new patients
The Methodist Hospitals, Inc Current Accepting new patients
McLaren Flint CurrentSince Sep 1, 2024 Accepting new patients
Suniti Medical Corporation Specialist CurrentSince Oct 7, 2022 Accepting new patients
Suniti Medical Corporation Specialist CurrentSince Oct 7, 2022 Accepting new patients
McLaren Flint Internal Medicine Past Accepting new patients

Locations

8701 Broadway
Merrillville, IN 46410
Phone (219) 738-4926

200 E 89th Ave
Merrillville, IN 46410
Phone (219) 738-4926

200 E 89th Ave
Ste 2A
Merrillville, IN 46410
Phone (219) 736-2800

929 Ridge Rd
Ste 5
Munster, IN 46321
Phone (219) 836-2000

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

4100 Beecher Rd
Ste B
Flint, MI 48532
Phone (810) 235-8568

Interoperability endpoints

  • Direct secure messaging: vatsala.katragadda@pomh.direct-geniusdoc.com
  • Direct secure messaging: vatsala.katragadda@poha.direct-geniusdoc.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531267200000",
    "number": "1841270634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "861 MONROE STREET",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242308",
            "telephone_number": "313-274-0774",
            "fax_number": "313-277-1140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "861 MONROE STREET",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "48124",
            "telephone_number": "313-274-1800",
            "fax_number": "313-274-8717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATRAGADDA",
        "first_name": "VATSALA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-19",
        "last_updated": "2018-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301066984",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301066984",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104623258",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.