Atul Medavaram, MD is a medicare enrolled "Hospitalist" physician in Garden City, Michigan. His current practice location is
6245 Inkster Rd, Garden City, Michigan. You can reach out to his office (for appointments etc.) via phone at
(734) 458-4486.
Atul Medavaram is licensed to practice in Illinois (license number 036162089) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1487215638.
Physician's Profile
Full Name | Atul Medavaram |
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Gender | Male |
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Speciality | Hospitalist |
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Location | 6245 Inkster Rd, Garden City, Michigan |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1487215638
- Provider Enumeration Date: 06/27/2019
- Last Update Date: 02/09/2024
Medicare PECOS Information:
- PECOS PAC ID: 0749690501
- Enrollment ID: I20231002002371
Medical Identifiers
Medical identifiers for Atul Medavaram such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1487215638 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207R00000X | Internal Medicine | 4351044756 (Michigan) | Secondary |
208M00000X | Hospitalist | 036162089 (Illinois) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Atul Medavaram allows following entities to bill medicare on his behalf.
Entity Name | 24 On Physicians Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1346480431 PECOS PAC ID: 5698688141 Enrollment ID: O20090609000389 |
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Entity Name | Cep America-illinois Hospitalists, Llp |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1841613403 PECOS PAC ID: 3274765904 Enrollment ID: O20140411001788 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Atul Medavaram is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Atul Medavaram, MD 6245 Inkster Rd, Garden City, MI 48135-4001 Ph: () - | Atul Medavaram, MD 6245 Inkster Rd, Garden City, MI 48135-4001 Ph: (734) 458-4486 |
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