Dr Chethana Chandrupatla Gottam, MD is a medicare enrolled "Dermatology" physician in Berkley, Michigan. She went to University Of Illinois College Of Med (chi/peor/rock/chm-urb) and graduated in 2005 and has 19 years of diverse experience with area of expertise as Dermatology. She is a member of the group practice Art Of Dermatology Pllc, Art Of Dermatology Pllc and her current practice location is
28903 Woodward Ave, Berkley, Michigan. You can reach out to her office (for appointments etc.) via phone at
(248) 581-0333.
Dr Chethana Chandrupatla Gottam is licensed to practice in Michigan (license number 4301108548) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1669664009.
Physician's Profile
| Full Name | Dr Chethana Chandrupatla Gottam |
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| Gender | Female |
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| Speciality | Dermatology |
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| Experience | 19 Years |
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| Location | 28903 Woodward Ave, Berkley, Michigan |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Chethana Chandrupatla Gottam attended and graduated from University Of Illinois College Of Med (chi/peor/rock/chm-urb) in 2005
NPI Data:
- NPI Number: 1669664009
- Provider Enumeration Date: 08/09/2007
- Last Update Date: 08/22/2018
Medicare PECOS Information:
- PECOS PAC ID: 8628121902
- Enrollment ID: I20130725000537
Medical Identifiers
Medical identifiers for Dr Chethana Chandrupatla Gottam such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1669664009 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207N00000X | Dermatology | ME116448 (Florida) | Secondary |
| 207N00000X | Dermatology | 036.122055 (Illinois) | Secondary |
| 207N00000X | Dermatology | 4301108548 (Michigan) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Art Of Dermatology Pllc | 9830441690 | 10 |
| Art Of Dermatology Pllc | 9830441690 | 10 |
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. Dr Chethana Chandrupatla Gottam allows following entities to bill medicare on her behalf.
| Entity Name | Art Of Dermatology Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1275022519
PECOS PAC ID: 9830441690
Enrollment ID: O20240208000225 |
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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. Dr Chethana Chandrupatla Gottam 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 |
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Dr Chethana Chandrupatla Gottam, MD
43900 Garfield Rd, Ste 100,
Clinton Township, MI 48038-1128
Ph: (586) 286-0112 | Dr Chethana Chandrupatla Gottam, MD
28903 Woodward Ave,
Berkley, MI 48072
Ph: (248) 581-0333 |
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