Prasad L Mikkilineni, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301039936 Issued in MI

Practice address

20206 Farmington Rd
Livonia, MI 48152-1412

Phone

(248) 476-4724

Fax

(248) 476-7091

NPI assigned

Aug 18, 2005

Last updated

Dec 24, 2007By the provider in NPPES

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 3

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

Specialty

Internal Medicine

Education

Other, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029
• Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053
• Marywood Nursing Care Center Nursing home, Livonia, MI, CCN 235530

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Marian Village Corporation

  dba Marywood Nursing Care Center/Marybrook Manor

  • Skilled Nursing Facility
  • Livonia, MI
  • NPI 1285721449

  Adp of the SNF, Corporate Officer

  CMS ownership

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.

• Prasad Mikkilineni MD PLLC

  • Internal Medicine Physician
  • Livonia, MI
  • NPI 1629582226
  Medicare reassignment NPD
• St Mary Mercy Physician Practices

  • Multi-Specialty Clinic/Center
  • Livonia, MI
  • NPI 1568630077
  Medicare reassignment NPD
• Iha Olma Primary Non Risk LLC

  dba St. Mary Mercy Center for Family Care

  • Family Medicine Physician
  • Livonia, MI
  • NPI 1073112819
  NPD
• St Mary Mercy Physician Practices

  dba St. Joe's Urgent Care - Livonia

  • Urgent Care Clinic/Center
  • Livonia, MI
  • NPI 1184154544
  NPD
• Marian Village Corporation

  dba Marywood Nursing Care Center/Marybrook Manor

  • Skilled Nursing Facility
  • Livonia, MI
  • NPI 1285721449
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Care Compare affiliation
• Marian Village Corporation

  dba Marywood Nursing Care Center/Marybrook Manor

  • Skilled Nursing Facility
  • Livonia, MI
  • NPI 1285721449

  Nursing home

  Care Compare affiliation
• St Joseph Mercy Hospital-SMHC

  dba St Joseph Mercy Oakland

  • General Acute Care Hospital
  • Pontiac, MI
  • NPI 1053356352
  Care Compare affiliation

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198454400000",
    "number": "1871585562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20206 FARMINGTON RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521412",
            "telephone_number": "248-476-4724",
            "fax_number": "248-476-7091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20206 FARMINGTON RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521412",
            "telephone_number": "248-476-4724",
            "fax_number": "248-476-7091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKKILINENI",
        "first_name": "PRASAD",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2007-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301039936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1108207022",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2908473",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1108207022",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Midwest Physical Medicine and Rehabilitation PLLC
• Erica Mifsud
• Michael Migliore, MM, BC-MT
• Brittni K Mihajlovic, DO
• Angela Mike
• Oktavijan Mikleus, NURSE PRACTITIONER
• Annalee Miklosek, BEHAVIOR TECHNICIAN
• James Edward Mikula, D.D.S.
• Jeremy Vincent Mileo
• Briyanna Miles

• Internal Medicine Physician in Livonia, MI
• Providers in Livonia, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.