NPIMap

Individual provider Active NPI

Neelakantam Jolepalem, M.D.

  • Psychiatry Physician
  • Pontiac, MI
National Provider Identifier
1861509093
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301042763 Issued in MI
Practice address
44555 Woodward Ave
Suite 405
Pontiac, MI 48341-5031
Phone
(248) 335-4010
Fax
(248) 858-3874
NPI assigned
Aug 24, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4301042763 MI Primary

Addresses

Primary practice location

44555 Woodward Ave
Suite 405
Pontiac, MI 48341-5031

Mailing address

44555 Woodward Ave
Suite 405
Pontiac, MI 48341-5031
Phone (248) 335-4010

Other identifiers 5

IdentifierTypeStateIssuer
260631846OtherMIBC/BS
750910401OtherMIBCBS
750910402OtherMIBCBS
042763OtherMILICENSE
19000659MedicaidMI

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Havenwyck Hospital Inc Psychiatry Past Accepting new patients
Neurohealth Associates PLC Psychiatry Past Accepting new patients
Rd Senior Care Services PC Past Accepting new patients
Genesys Practice Partners, Inc Psychiatry Past Accepting new patients
Henry Ford Health Eastwood Behavioral Health Past Accepting new patients
St. Joseph Mercy Hospital Crna Group Past Accepting new patients
Genesys Ambulatory Health Services, Inc. Past Accepting new patients
CNS Healthcare Psychiatry Past Accepting new patients
Genesys Practice Partners, Inc. Past Accepting new patients
Genesys Practice Partners, Inc. Psychiatry Past Accepting new patients

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1861509093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44555 WOODWARD AVE",
            "address_2": "SUITE 405",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415031",
            "telephone_number": "248-335-4010",
            "fax_number": "248-858-3874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44555 WOODWARD AVE",
            "address_2": "SUITE 405",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415031",
            "telephone_number": "248-335-4010",
            "fax_number": "248-858-3874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLEPALEM",
        "first_name": "NEELAKANTAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301042763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "260631846",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "750910401",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "750910402",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "042763",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19000659",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.