Active NPI
Prathapraju Poloju
- Internal Medicine Physician
- Flint, MI
National Provider Identifier
1902258171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 320940
- Practice address
- 401 S Ballenger Hwy
Flint, MI 48532-3638 - Phone
- (810) 342-2000
- Fax
- (810) 342-1591
- NPI assigned
- Jul 12, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 4301110700 | MI | |
| Internal Medicine Physician | 207R00000X | 320940 | LA | Primary |
Addresses
Primary practice location
401 S Ballenger Hwy
Flint, MI 48532-3638
Mailing address
401 S Ballenger Hwy
Flint, MI 48532-3638
Phone (810) 342-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3330 Masonic Dr
Alexandria, LA 71301-3841
Phone (318) 487-1122
Hospital & facility affiliations
- Christus St Frances Cabrini Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 320940 | LA | MD | Internal Medicine Physician |
| 4301110700 | MI | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Louisiana Physicians, LLC | Internal Medicine | Current | Accepting new patients |
| Cogent Healthcare of Texas, PA | Internal Medicine | Current | Accepting new patients |
| Hospitalist Medicine Physicians of Texas, PLLC | Internal Medicine | Current | Accepting new patients |
| Christus Health Central Louisiana | Past | Accepting new patients |
Locations
3330 Masonic Dr
Alexandria, LA 71301
Phone (318) 448-6917
4200 Nelson Rd
Lake Charles, LA 70605
Phone (318) 474-6370
1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 681-4138
5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674
Organizations & group practices 4
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.
-
- Internal Medicine Physician
- Alexandria, LA
- NPI 1417738675
-
- Internal Medicine Physician
- Humble, TX
- NPI 1629307095
LA
-
- General Acute Care Hospital
- Alexandria, LA
- NPI 1639160799
Hospital & facility affiliations 18
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Student Health Clinic/Center
- Pineville, LA
- NPI 1023139458
Hospital
-
- Student Health Clinic/Center
- Pineville, LA
- NPI 1093836421
Hospital
-
- Student Health Clinic/Center
- Provencal, LA
- NPI 1164687307
Hospital
-
- Student Health Clinic/Center
- Natchitoches, LA
- NPI 1356462782
Hospital
-
- Student Health Clinic/Center
- Marthaville, LA
- NPI 1609031962
Hospital
-
- General Acute Care Hospital
- Alexandria, LA
- NPI 1639160799
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577664000000",
"number": "1902258171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 S BALLENGER HWY",
"city": "FLINT",
"state": "MI",
"postal_code": "485323638",
"telephone_number": "810-342-2000",
"fax_number": "810-342-1591"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 S BALLENGER HWY",
"city": "FLINT",
"state": "MI",
"postal_code": "485323638",
"telephone_number": "810-342-2000",
"fax_number": "810-342-1591"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLOJU",
"first_name": "PRATHAPRAJU",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-12",
"last_updated": "2019-12-30",
"certification_date": "2019-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MI",
"license": "4301110700",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "LA",
"license": "320940",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flint, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.