Active NPI
Raja Sekhar Reddy Madathala, MD
- Internal Medicine Physician
- Ypsilanti, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- EMO0004721
- Practice address
- Iha Hospital Medicine Services
5301 E Huron River Drive
Ypsilanti, MI 48197 - Phone
- (734) 712-8676
- NPI assigned
- Dec 9, 2011
- Last updated
- Aug 26, 2024
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 125059044 | IL | |
| Internal Medicine Physician | 207R00000X | 61887 | MN | |
| Internal Medicine Physician | 207R00000X | EMO0004721 | MI | Primary |
| Hospitalist Physician | 208M00000X | 61887 | MN |
Addresses
Primary practice location
Iha Hospital Medicine Services
5301 E Huron River Drive
Ypsilanti, MI 48197
Mailing address
24 Frank Lloyd Wright Drive
Suite J2000
Ann Arbor, MI 48105
Phone (734) 747-6766
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN, MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
36475 5 Mile Rd
Livonia, MI 48154-1971
Phone (734) 583-9125
44428 Woodward Ave
Suite 102
Pontiac, MI 48341-5009
Phone (734) 712-8700
51341 W Huron River Dr
Trinity Health Iha Medical Group Primary Ca
Van Buren Township, MI 48111-2571
Phone (734) 997-0304
5301 E Huron River Dr
Ypsilanti, MI 48197-1051
5301 McAuley Dr
Ypsilanti, MI 48197-1051
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125059044 | IL | MD | Internal Medicine Physician |
| EMO0004721 | MI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mayo Clinic Health System-Southeast Minnesota Region | Current | Accepting new patients | |
| Mayo Clinic Health System-Lake City | Current | Accepting new patients | |
| Iha Health Services Corporation | Hospitalist | Current | Accepting new patients |
| Mayo Clinic Health System-Fairmont | Current | Accepting new patients | |
| Iha Health Services Corporation | Current | Accepting new patients | |
| Mayo Clinic Health System-Southwest Minnesota Region | Current | Accepting new patients | |
| Mayo Clinic Health System-Lake City | Current | Accepting new patients | |
| Mayo Clinic Health System-Southwest Minnesota Region | Current | Accepting new patients | |
| Mayo Clinic Health System-Southeast Minnesota Region | Current | Accepting new patients | |
| Iha Health Service Corporation | Current | Accepting new patients | |
| Mayo Clinic Health System-Southeast Minnesota Region | Current | Accepting new patients | |
| St Joseph Mercy Hospital | Past | Accepting new patients | |
| St Mary Mercy Hospital | Past | Accepting new patients |
Locations
24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400
44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700
5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246
404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285
1000 1st Dr NW
Austin, MN 55912
Phone (507) 433-7351
32021 County 24 Blvd
Cannon Falls, MN 55009
Phone (507) 263-6000
800 Medical Center Dr
Fairmont, MN 56031
Phone (507) 238-8100
500 W Grant St
Lake City, MN 55041
Phone (651) 345-3321
1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623
200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850
Interoperability endpoints
- rmadathala3497357@direct.trinity-health.org
Organizations & group practices 13
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.
-
dba IHA Canton Obstetrics and Gynecology
- Obstetrics & Gynecology Physician
- Canton, MI
- NPI 1457408965
-
- Multi-Specialty Clinic/Center
- Fairmont, MN
- NPI 1366410862
-
- Multi-Specialty Clinic/Center
- Lake City, MN
- NPI 1164463659
-
- Critical Access Hospital
- Lake City, MN
- NPI 1538113022
-
dba Mayo Clinic Health System-Cannon Falls
- Critical Access Hospital
- Cannon Falls, MN
- NPI 1063435410
-
dba Mayo Clinic Health System-Albert Lea and Austin
- Multi-Specialty Clinic/Center
- Albert Lea, MN
- NPI 1891701637
-
dba Mayo Clinic Health System - Mankato
- Multi-Specialty Clinic/Center
- Mankato, MN
- NPI 1578545422
-
dba Trinity Health IHA Medical Group OB/GYN Float
- Obstetrics & Gynecology Physician
- Ypsilanti, MI
- NPI 1831053701
-
dba IHA Hospitalist
- Hospitalist Physician
- Ypsilanti, MI
- NPI 1306121405
-
dba Mayo Clinic Health System Pharmacy - Cannon Falls
- Clinic Pharmacy
- Cannon Falls, MN
- NPI 1699597468
-
dba Mayo Clinic Health System-Waseca
- Multi-Specialty Clinic/Center
- Waseca, MN
- NPI 1518494251
-
dba Trinity Heath Ann Arbor Hospital
- General Acute Care Hospital
- Ypsilanti, MI
- NPI 1780658443
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Trinity Heath Ann Arbor Hospital
- General Acute Care Hospital
- Ypsilanti, MI
- NPI 1780658443
-
- General Acute Care Hospital
- Livonia, MI
- NPI 1790706901
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724630400000",
"number": "1932477536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 FRANK LLOYD WRIGHT DRIVE",
"address_2": "SUITE J2000",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "48105",
"telephone_number": "734-747-6766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "IHA HOSPITAL MEDICINE SERVICES",
"address_2": "5301 E HURON RIVER DRIVE",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "48197",
"telephone_number": "734-712-8676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADATHALA",
"first_name": "RAJA SEKHAR",
"middle_name": "REDDY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-12-09",
"last_updated": "2024-08-26",
"certification_date": "2024-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "125059044",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MN",
"license": "61887",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "EMO0004721",
"primary": true
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "MN",
"license": "61887",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ypsilanti, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.