Active NPI
Adam Cardullo, M.D.
- Pediatric Gastroenterology Physician
- Ann Arbor, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Gastroenterology Physician
- License
- 4301509755
- Practice address
- 1500 E Medical Center Dr
Ann Arbor, MI 48109-5000 - Phone
- (734) 936-4000
- NPI assigned
- Mar 24, 2017
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 10955777-1205 | UT | |
| Pediatric Gastroenterology Physician | 2080P0206X | 4301509755 | MI | Primary |
Addresses
Primary practice location
1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Mailing address
3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299
Other practice location 1
81 N Mario Capecchi Dr
Salt Lake City, UT 84113-1125
Phone (801) 662-5700
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
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Tufts University School of Dental Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1500 E Medical Ctr
Suite 0331
Ann Arbor, MI 48109-0999
Phone (734) 936-5738
1500 E Medical Ctr 2ND Floor Rec
Taubman Center
Ann Arbor, MI 48109-0999
Phone (734) 936-5020
1500 E Medical Ctr Dr
Ann Arbor, MI 48109-0999
1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000
1500 E Medical Ctr Dr 1St FL
Taubman Ctr Rec D
Ann Arbor, MI 48109-5000
Phone (734) 936-4185
1500 E Medical Ctr Dr 1St FL Rec D
Taubman Center
Ann Arbor, MI 48109-5000
Phone (734) 764-5175
1500 E Medical Ctr Dr 1St FL Rec F
Mott Hospital
Ann Arbor, MI 48109-5000
Phone (734) 764-5176
1500 E Medical Ctr Dr 1St Flo
Ann Arbor, MI 48109-0999
1500 E Medical Ctr Dr 1St Floor
Ann Arbor, MI 48109-0999
1500 E Medical Ctr Dr 2ND LR
Med Inn
Ann Arbor, MI 48109-0999
Phone (734) 763-5459
1500 E Medical Ctr Dr 3Rd FL Taubma
Ann Arbor, MI 48109-5000
Phone (734) 647-7321
1500 E Medical Ctr Dr B2 Floor R
Cancer and Geriatrics Center
Ann Arbor, MI 48109-0999
Phone (734) 936-6274
1500 E Medical Ctr Dr Level B
Cancer and Geriatrics Center
Ann Arbor, MI 48109-0999
Phone (734) 647-8901
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10955777-1205 | UT | MD | Pediatrics Physician |
| 4301509755 | MI | MD | Pediatric Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SJMH Medical Practice-SMHC | Current | Accepting new patients | |
| Regents of the University of Michigan | Pediatrics | Current | Accepting new patients |
| Regents of the University of Michigan | Pediatrics | Current | Accepting new patients |
| Regents of the University of Michigan | Current | Accepting new patients | |
| SJMH Medical Practice-SMHC | Pediatrics | Current | Accepting new patients |
| Regents of the University of Michigan | Past | Accepting new patients |
Locations
1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280
3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229
20555 Victor Pkwy
Livonia, MI 48152
Phone (734) 343-3925
44405 Woodward Ave
Pontiac, MI 48341
Phone (248) 858-3000
Interoperability endpoints
- acardullo3359016@direct.trinity-health.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.
-
- Internal Medicine Physician
- Ann Arbor, MI
- NPI 1205868353
Pediatrics
-
- Pediatric Gastroenterology Physician
- Ann Arbor, MI
- NPI 1346274933
Pediatrics
-
- Specialty Pharmacy
- Dexter, MI
- NPI 1952181919
-
- Urgent Care Clinic/Center
- Waterford, MI
- NPI 1366644551
-
- General Acute Care Hospital
- Ann Arbor, MI
- NPI 1003878539
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490313600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694736000000",
"number": "1952832503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3621 S STATE ST",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481081633",
"telephone_number": "734-647-5299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 E MEDICAL CENTER DR",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481095000",
"telephone_number": "734-936-4000"
}
],
"practiceLocations": [
{
"address_1": "81 N Mario Capecchi Dr",
"address_purpose": "LOCATION",
"city": "Salt Lake City",
"state": "UT",
"postal_code": "841131125",
"country_code": "US",
"telephone_number": "801-662-5700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CARDULLO",
"first_name": "ADAM",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-24",
"last_updated": "2023-09-15",
"certification_date": "2023-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "UT",
"license": "10955777-1205",
"primary": false
},
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "MI",
"license": "4301509755",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; 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.