NPIMap

Individual provider Active NPI

Sujay Madduri, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Midland, MI
National Provider Identifier
1962738351
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
4301105433 Issued in MI
Practice address
301 W Wackerly St
Midland, MI 48640-2761
Phone
(989) 488-5850
Fax
(989) 488-5865
NPI assigned
Oct 20, 2009
Last updated
Aug 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 4301105433 MI Primary

Addresses

Primary practice location

301 W Wackerly St
Midland, MI 48640-2761

Mailing address

4201 Campus Ridge Drive
Midland, MI 48640
Phone (989) 488-5850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140723000739 MI Practitioner - Endocrinology 3870719107 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mymichigan Medical Center MidlandGroup PAC ID 2264323633, 507 clinicians

Practice addresses (Care Compare)

301 W Wackerly St
Mymichigan Endocrinology Diabetes C
Midland, MI 48640-2761
Phone (989) 488-5850

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Midland CurrentSince Jul 1, 2015 Accepting new patients
Mymichigan Medical Center Midland CurrentSince Jul 1, 2015 Accepting new patients
Mymichigan Medical Group Current Accepting new patients

Locations

609 Quarter St
Gladwin, MI 48624
Phone (989) 246-6371

815 N Clare Ave
Harrison, MI 48625
Phone (989) 539-4096

301 W Wackerly St
Midland, MI 48640
Phone (989) 488-5850

301 W Wackerly St
#C
Midland, MI 48640
Phone (989) 488-5850

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

4201 Campus Ridge Dr
Ste 3000
Midland, MI 48640
Phone (989) 488-5450

4201 Campus Ridge Dr
Ste 3200
Midland, MI 48640
Phone (989) 488-5850

4201 N Campus Ridge Dr
Midland, MI 48640
Phone (989) 488-5450

4500 N Campus Ridge Dr
Midland, MI 48640
Phone (989) 837-9250

Interoperability endpoints

  • Direct secure messaging: smadduri6693@mymichiganhealth.midirect.net

Organizations & group practices 3

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.

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1962738351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 CAMPUS RIDGE DRIVE",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "48640",
            "telephone_number": "989-488-5850",
            "fax_number": "989-488-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W WACKERLY ST",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486402761",
            "telephone_number": "989-488-5850",
            "fax_number": "989-488-5865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDURI",
        "first_name": "SUJAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-20",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MI",
            "license": "4301105433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.