SUJITH KUMAR SAMUDRALA
NPI 1205332228
Student in an Organized Health Care Education/Training Program in Detroit, MI

Q: What is Sujith Samudrala's NPI number?

The NPI number for Sujith Samudrala is 1205332228. It was assigned to this individual provider in the NPPES registry on March 30, 2018.

Q: What is Sujith Samudrala's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Sujith Samudrala was last updated on March 30, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 30, 2018PECOS Enrolled

6071 W OUTER DR, DETROIT, MI 48235(313) 966-1003 Get Directions Write a Review

NPPES record last updated: March 30, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Sujith Kumar Samudrala NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUJITH KUMAR SAMUDRALA (NPI 1205332228) is an individual student in an organized health care education/training program in Detroit, Michigan and active in the NPI registry since March 2018. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205332228

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameSUJITH KUMAR SAMUDRALA

Location Address6071 W OUTER DRDetroit, MI 48235-2624

Mailing Address1352 W Sunset Rd Apt 219Port Washington, WI 53074-2450 · (515) 306-7127

Phone(313) 966-1003

Sole ProprietorNo

Enumeration DateMarch 30, 2018

✔ NPI 1205332228 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

6071 W OUTER DR, Detroit, MI 48235

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sujith Kumar Samudrala is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. LILIA POPADIUK P.A.

Physician Assistant