Individual provider Active NPI

Vashudevan Mittal, MD

  • Student in an Organized Health Care Education/Training Program
  • Detroit, MI
National Provider Identifier
1861281610
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
6071 W Outer Drive
Detroit, MI 48235
Phone
(313) 966-7434
NPI assigned
May 6, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

6071 W Outer Drive
Detroit, MI 48235

Mailing address

6071 W Outer Drive
Detroit, MI 48235
Phone (313) 966-7434

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
I20251030002902 MI Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 0648769547

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1746489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1861281610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6071 W OUTER DRIVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48235",
            "telephone_number": "313-966-7434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6071 W OUTER DRIVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48235",
            "telephone_number": "313-966-7434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTAL",
        "first_name": "VASHUDEVAN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-06",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.