NPIMap

Individual provider Active NPI

Ajith K Kadakol, M.D.

  • Vascular Surgery Physician
  • Rochester Hills, MI
National Provider Identifier
1891742128
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
AK093222 Issued in MI
Practice address
1701 South Blvd E Ste B75
Rochester Hills, MI 48307-6122
Phone
(248) 243-3935
Fax
(248) 284-7530
NPI assigned
May 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X 223607 MA
Vascular Surgery Physician 2086S0129X AK093222 MI Primary

Addresses

Primary practice location

1701 South Blvd E Ste B75
Rochester Hills, MI 48307-6122

Mailing address

3205 Legacy CT
W Bloomfield, MI 48323-3634
Phone (248) 243-3935

Other practice location 1

One Boston Medical Ctr. Pl.
Boston Medical Center
Boston, MA 02118
Phone (617) 638-8442

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110428000033 MI Practitioner - Vascular Surgery 2062697402 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

1 Ford PL
Detroit, MI 48202-3450
Phone (313) 874-6677

15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone (586) 263-2300

1701 S Blvd E
Suite B75
Rochester Hills, MI 48307-6126
Phone (248) 243-3935

2799 W Grand Blvd
Detroit, MI 48202-2608

6773 W Maple Rd
West Bloomfield, MI 48322-3013
Phone (248) 661-6100

6777 W Maple Rd
West Bloomfield, MI 48322-3013
Phone (248) 661-6470

Hospital & facility affiliations

  • Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047
  • Henry Ford Health West Bloomfield Hospital Hospital, W Bloomfield, MI, CCN 230302
  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053
  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
  • Ascension Providence Rochester Hospital Hospital, Rochester, MI, CCN 230254

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal44
Leg revascularization (restoring blood flow)40
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
223607MAMDPediatric Surgery Physician
AK093222MIMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Current Accepting new patients
Henry Ford Health System Vascular Surgery CurrentSince Aug 22, 2011 Accepting new patients
Henry Ford Health System CurrentSince Aug 22, 2011 Accepting new patients
S.S.Hans,M.D.,P.C. Vascular Surgery Past Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients

Locations

2799 W Grand Blvd
#K8
Detroit, MI 48202
Phone (313) 916-1755

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

Interoperability endpoints

  • Direct secure messaging: akadakol14187@direct.hfhs.org

Organizations & group practices 6

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 8

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": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1891742128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 LEGACY CT",
            "city": "W BLOOMFIELD",
            "state": "MI",
            "postal_code": "483233634",
            "telephone_number": "248-243-3935",
            "fax_number": "248-284-7530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 SOUTH BLVD E STE B75",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483076122",
            "telephone_number": "248-243-3935",
            "fax_number": "248-284-7530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "One Boston Medical Ctr. Pl.",
            "address_2": "Boston Medical Center",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "02118",
            "country_code": "US",
            "telephone_number": "617-638-8442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KADAKOL",
        "first_name": "AJITH",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "MA",
            "license": "223607",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MI",
            "license": "AK093222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

Verify at the official NPI Registry.