Nobin J Kottukapally, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301094236 Issued in MI

Practice address

2001 S Merriman Rd
Suite 100
Westland, MI 48186-5539

Phone

(585) 279-4800

Fax

(585) 244-9048

NPI assigned

Sep 3, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Family PracticeAlso: Obstetrics/Gynecology

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oakwood Ambulatory LLCGroup PAC ID 1850282914, 271 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Corewell Health Wayne Hospital Hospital, Wayne, MI, CCN 230142
• Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Oakwood Ambulatory LLC

  • Internal Medicine Physician
  • Dearborn, MI
  • NPI 1003829441

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Oakwood Healthcare, Inc.

  • Diagnostic Radiology Physician
  • Dearborn, MI
  • NPI 1336174440
  Medicare reassignment NPD
• Oakwood Ambulatory, LLC

  • Podiatrist
  • Westland, MI
  • NPI 1013157361
  NPD
• Oakwood Healthcare Inc

  • Community/Retail Pharmacy
  • Westland, MI
  • NPI 1033128178
  NPD
• Oakwood Healthcare, Inc

  • Surgery Physician
  • Dearborn, MI
  • NPI 1861666265
  NPD
• Oakwood Healthcare, Inc.

  • General Acute Care Hospital
  • Wayne, MI
  • NPI 1295785285
  NPD (past)
• Oakwood Healthcare, Inc.

  • General Acute Care Hospital
  • Dearborn, MI
  • NPI 1740230119
  NPD (past)
• Oakwood Youth Programs, LLC

  • Physical Medicine & Rehabilitation Physician
  • Dearborn, MI
  • NPI 1790959120
  NPD (past)

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

• Oakwood Healthcare Inc

  • Community Health Clinic/Center
  • Dearborn, MI
  • NPI 1790414670

  Hospital

  Care Compare affiliation
• Oakwood Healthcare, Inc.

  • General Acute Care Hospital
  • Wayne, MI
  • NPI 1295785285
  Care Compare affiliation
• Oakwood Healthcare, Inc.

  • General Acute Care Hospital
  • Dearborn, MI
  • NPI 1740230119
  Care Compare affiliation

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

{
    "created_epoch": "1251936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1942433289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50375 UPTOWN AVE",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481876662",
            "telephone_number": "810-877-0848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S MERRIMAN RD",
            "address_2": "SUITE 100",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481865539",
            "telephone_number": "585-279-4800",
            "fax_number": "585-244-9048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTTUKAPALLY",
        "first_name": "NOBIN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-03",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "266204",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301094236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nkottukapally122955@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "2001 S Merriman Rd",
            "address_2": "Suite 100",
            "city": "Westland",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481865539",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jessica Kole, PHARMD
• Harold P Kopitzki, DO
• Tamera Lynn Kosa, RN
• Vijay Kumar Kotha, MD
• Kathy Koths
• Amy Ok Kowalski, OTR/L
• Sonya Kowalski
• Tamara M. Kozlowski, MSW LLMSW
• Joyce Marie Krause, OTR
• Kroger Co of Michigan

• Family Medicine Physician in Westland, MI
• Providers in Westland, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; 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.

Verify at the official NPI Registry.