Active NPI
Santhi Nimmagadda, MD
- Nephrology Physician
- Dearborn, MI
National Provider Identifier
1922029958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 4301076231
- Practice address
- 19001 Hubbard Dr
Dearborn, MI 48126-2637 - Phone
- (313) 441-1160
- Fax
- (313) 441-1870
- NPI assigned
- Jul 23, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 4301076231 | MI | Primary |
Addresses
Primary practice location
19001 Hubbard Dr
Dearborn, MI 48126-2637
Mailing address
19001 Hubbard Dr
Dearborn, MI 48126-2637
Phone (313) 441-1160
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04783 | Other | PARAMOUNT | |
| 000000390002 | Other | ANTHEM BCBS | |
| 2621176 | Medicaid | OH |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080119000101 | MI | Practitioner - Nephrology | 3072527761 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nephrology
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Henry Ford Health System
Practice addresses (Care Compare)
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600
Hospital & facility affiliations
- Greenfield HS - Dearborn
- Henry Ford Health Hospital
- Wyandotte Hospital and Medical Center
- Henry Ford Wyandotte Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Health System | Current | Accepting new patients | |
| Henry Ford Pathology | Current | Accepting new patients | |
| Henry Ford Health System | Nephrology | Current | Accepting new patients |
| Henry Ford Health System | Current | Accepting new patients |
Locations
19001 Hubbard Dr
Dearborn, MI 48126
Phone (313) 441-1160
2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062
1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953
Interoperability endpoints
- snimmagadda16934@direct.hfhs.org
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.
-
- Community/Retail Pharmacy
- Plymouth, MI
- NPI 1942931720
-
- Anatomic Pathology & Clinical Pathology Physician
- Detroit, MI
- NPI 1851410005
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Dearborn, MI
- NPI 1568482958
Dialysis facility
-
- Ambulatory Surgical Clinic/Center
- Wyandotte, MI
- NPI 1093901035
Hospital
-
- Rehabilitation Hospital
- Wyandotte, MI
- NPI 1982853560
Inpatient rehabilitation facility
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195171200000",
"number": "1922029958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19001 HUBBARD DR",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481262637",
"telephone_number": "313-441-1160",
"fax_number": "313-441-1870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19001 HUBBARD DR",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481262637",
"telephone_number": "313-441-1160",
"fax_number": "313-441-1870"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIMMAGADDA",
"first_name": "SANTHI",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-23",
"last_updated": "2007-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "MI",
"license": "4301076231",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARAMOUNT",
"identifier": "04783",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000390002",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2621176",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; 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.