Sushruth Reddy Moku, DO

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

5151013968 Issued in MI

Practice address

10000 Telegraph Rd
Taylor, MI 48180-3330

Phone

(313) 295-5000

NPI assigned

Jun 21, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, SC2 enrollments

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 2

Specialty

Physical Medicine and Rehabilitation

Education

Lake Erie College of Osteopathic Medicine, Erie, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hartsville Medical Group LLCGroup PAC ID 7012062714, 78 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carolina Pines Regional Medical Center Hospital, Hartsville, SC, CCN 420010
• McLeod Regional Medical Center-Pee Dee Hospital, Florence, SC, CCN 420051

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8689/brand/1/csg/1/fhir/r4
• Direct secure messaging: sushruth.moku.1@8689.direct.athenahealth.com

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.

• Hartsville Medical Group LLC

  • Internal Medicine Physician
  • Hartsville, SC
  • NPI 1598995300

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Virginia I-Spine Physicians, P.C

  • Physical Medicine & Rehabilitation Physician
  • Richmond, VA
  • NPI 1184913584

  Single Specialty

  Medicare reassignment NPD
• Anesthesia Solutions PLLC

  • Certified Registered Nurse Anesthetist
  • Richmond, VA
  • NPI 1215402169

  Single Specialty

  NPD (past)

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

• Hartsville, LLC

  dba Carolina Pines Regional Medical Center

  • General Acute Care Hospital
  • Hartsville, SC
  • NPI 1174500458
  Care Compare affiliation
• McLeod Regional Medical Center of the Pee Dee, Inc.

  • General Acute Care Hospital
  • Florence, SC
  • NPI 1699756221
  Care Compare affiliation

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

{
    "created_epoch": "1561075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561075200000",
    "number": "1972164986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1859 PRESERVE BLVD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481882221",
            "telephone_number": "607-731-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 TELEGRAPH RD",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481803330",
            "telephone_number": "313-295-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOKU",
        "first_name": "SUSHRUTH",
        "middle_name": "REDDY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-21",
        "last_updated": "2019-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "5151013968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ijauh Mitchell
• Modern Psych and Wellness PLLC
• Yekta Mohammad Zadeh
• Nizamuddin Mohammad
• Marium Mohammed Iqbal, MD
• Lori Monette Mollon, RN
• Andrea M Molnar, PHARMD
• Anna Monkmeyer, LMSW
• Donna Lynn Moore, LLBSW
• Faith Moore

• Physical Medicine & Rehabilitation Physician in Taylor, MI
• Providers in Taylor, MI by specialty
• Physical Medicine & Rehabilitation Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2019; 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.