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KRISHNA POTHUGUNTA M.D
NPI 1285869982
Internal Medicine in Troy, MI

Active since May 26, 2009PECOS EnrolledAccepts Medicare Assignment
4600 INVESTMENT DR, SUITE 290, TROY, MI 48098(248) 267-5010 Get Directions Write a Review

NPPES record last updated: February 3, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Krishna Pothugunta M.d NPPES

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

KRISHNA POTHUGUNTA M.D (NPI 1285869982) is an individual internal medicine provider in Troy, Michigan, licensed in Michigan (4301093847) and active in the NPI registry since May 2009. She is enrolled in Medicare PECOS, is affiliated with Beaumont Hospital - Dearborn, and is a graduate of Other (2007).

NPPES Registry Identity

NPI1285869982
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameKRISHNA POTHUGUNTACredential: M.D
Location Address4600 INVESTMENT DR, SUITE 290Troy, MI 48098-6365
Mailing Address4600 Investment Dr, Suite 290Troy, MI 48098-6365 · (248) 267-5010
Phone(248) 267-5010
Sole ProprietorNo
Medical School CMSOtherGraduated 2007
Enumeration DateMay 26, 2009
Last NPPES UpdateFebruary 3, 2016
✔ NPI 1285869982 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MI · 4301093847
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedInternal Medicine · NephrologyTaxonomy 207RN0300X · License 4301093847 (MI)
4600 INVESTMENT DR, Troy, MI 48098
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Krishna Pothugunta M.d is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1759504111
PECOS Enrollment IDI20140603002359
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.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
691 services199 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
517 services250 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
152 services71 patients
Hemodialysis procedure with physician evaluation 90935
Hemodialysis is a treatment that uses a machine to filter waste and excess fluid from your blood when your kidneys can't. A physician checks your health before, during, and after the procedure to ensure it's working effectively for you.
128 services47 patients
Dialysis services, 4 or more physician visits per month (20 years or older) 90960
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.
123 services24 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
97 services73 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Beaumont Hospital - Dearborn

Acute Care Hospitals · Dearborn, MI
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230020
Location18101 Oakwood BlvdDearborn, MI 48124 · Wayne County
Emergency services Birthing friendly

Beaumont Hospital - Grosse Pointe

Acute Care Hospitals · Grosse Pointe, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230089
Location468 Cadieux RdGrosse Pointe, MI 48230 · Wayne County
Emergency services Birthing friendly

Beaumont Hospital Royal Oak

Acute Care Hospitals · Royal Oak, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230130
Location3601 W Thirteen Mile RdRoyal Oak, MI 48073 · Oakland County
Emergency services Birthing friendly

Beaumont Hospital - Farmington Hills

Acute Care Hospitals · Farmington Hills, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230151
Location28050 Grand River AvenueFarmington Hills, MI 48336 · Oakland County
Emergency services Birthing friendly

Beaumont Hospital, Troy

Acute Care Hospitals · Troy, MI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230269
Location44201 Dequindre RoadTroy, MI 48085 · Oakland County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48098 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$134.28 typical visit price
range $58.04 – $177.36
Typical copayment $33.57 (range $14.51 – $44.34)
Most-billed visit code 99204
Established Patient
$102.35 typical visit price
range $18.32 – $143.49
Typical copayment $25.58 (range $4.58 – $35.87)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Clinical Information Reconciliation
For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician performs clinical information reconciliation.
84%1,094 patients4/55-star benchmark: 100%
Diabetes: Foot Exam
The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year
1%112 patients1/55-star benchmark: 98%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
86%1,270 patients3/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
90%1,081 patients4/55-star benchmark: 100%
Patient-Generated Health Data
Patient-generated health data or data from a non-clinical setting is incorporated into the certified EHR technology for at least one unique patient seen by the MIPS eligible clinician during the performance period.
41%511 patients
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible…
99%511 patients4/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
43%326 patients2/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
99%507 patients5/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 100% · 291 patients
Patients tobacco: 96% · 291 patients
45%20 patients2/55-star benchmark: 98%
Provide Patient Access
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician…
97%511 patients4/55-star benchmark: 100%
Request/Accept Summary of Care
For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician receives or retrieves and incorporates into the patient's record an…
2%1,068 patients1/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of certified EHR technology to the patient (or the patient-authorized representative), or in…
41%511 patients3/55-star benchmark: 75%
Send a Summary of Care
For at least one transition of care or referral, the MIPS eligible clinician that transitions or refers their patient to another setting of care or health care provider-(1) creates a summary of care record using certified EHR technology; and (2)…
62%151 patients3/55-star benchmark: 100%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 326 patients
0%326 patients5/55-star benchmark: 100%
View, Download and Transmit (VDT)
During the performance period, at least one unique patient (or patient-authorized representatives) seen by the MIPS eligible clinician actively engages with the EHR made accessible by the MIPS eligible clinician.
6%511 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tacrolimus, immediate release, oral, 1 mg J7507
Treatment-Treatment - Miscellaneous · category RX029N
5 suppliers26 claims1,586 services$0.28 avg. paid by Medicare
Prednisone, immediate release or delayed release, oral, 1 mg J7512
Treatment-Treatment - Miscellaneous · category RX029N
2 suppliers15 claims1,830 services$0.01 avg. paid by Medicare
Mycophenolate mofetil, oral, 250 mg J7517
Treatment-Treatment - Miscellaneous · category RX029N
5 suppliers33 claims3,718 services$0.19 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511
Treatment-Chemotherapy · category RH012N
5 suppliers23 claims23 services$18.92 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512
Treatment-Chemotherapy · category RH012N
6 suppliers61 claims64 services$12.58 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

DR. MEHMET E DONAT MD
Internal Medicine (Gastroenterology)
4600 INVESTMENT DR, STE 380
TROY, MI 48098
Oakland County (248) 267-5025
DR. TIMOTHY J TINETTI MD
Internal Medicine
4600 INVESTMENT DR, STE 300
TROY, MI 48098
Oakland County (248) 267-5000
DR. DAVID J KEARNEY MD
Urology
4600 INVESTMENT DR, STE 370
TROY, MI 48098
Oakland County (248) 267-5035
DR. SUNDEEP S DHILLON MD
Internal Medicine (Nephrology)
4600 INVESTMENT DR, STE 290
TROY, MI 48098
Oakland County (248) 267-5010
DR. JANET K DUBECK MD
Internal Medicine
4600 INVESTMENT DR, STE 300
TROY, MI 48098
Oakland County (248) 267-5000
MICHIGAN HEART GROUP PC
Internal Medicine (Cardiovascular Disease)
4600 INVESTMENT DR, SUITE 200
TROY, MI 48098
Oakland County (248) 267-5050
WILLIAM BEAUONT HOSPITAL
Internal Medicine
4600 INVESTMENT DR
TROY, MI 48098
Oakland County (616) 486-6790
DR. LEONARD G QUALLICH III MD
Internal Medicine (Gastroenterology)
4600 INVESTMENT DR, STE 380
TROY, MI 48098
Oakland County (248) 267-5025

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Krishna Pothugunta's NPI number?

The NPI number for Krishna Pothugunta is 1285869982. It was assigned to this individual provider in the NPPES registry on May 26, 2009.

Where is Krishna Pothugunta located?

Krishna Pothugunta practices at 4600 Investment Dr Suite 290, Troy, MI 48098. The listed phone number is (248) 267-5010.

What is Krishna Pothugunta's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Krishna Pothugunta enrolled in Medicare?

Yes. Krishna Pothugunta is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Krishna Pothugunta accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 2 other insurers list Krishna Pothugunta as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Krishna Pothugunta affiliated with any hospitals?

According to CMS data, Krishna Pothugunta is affiliated with Beaumont Hospital - Dearborn, Beaumont Hospital - Grosse Pointe, Beaumont Hospital Royal Oak, Beaumont Hospital - Farmington Hills and Beaumont Hospital, Troy.

When was this NPI record last updated?

The NPPES record for Krishna Pothugunta was last updated on February 3, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.