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VIJAYA MAMIDIPAKA M.D.
NPI 1295770394
Family Medicine in Plymouth, MI

Active since June 20, 2006PECOS Enrolled
47500 FFVE MILE ROAD, PLYMOUTH, MI 48170(734) 459-7400(734) 459-7403 Get Directions Write a Review

NPPES record last updated: April 29, 2009. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Vijaya Mamidipaka M.d. NPPES

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

VIJAYA MAMIDIPAKA M.D. (NPI 1295770394) is an individual family medicine provider in Plymouth, Michigan, licensed in Michigan (4301082641) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1295770394
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameVIJAYA MAMIDIPAKACredential: M.D.
Location Address47500 FFVE MILE ROADPlymouth, MI 48170
Mailing Address47500 Five Mile RdPlymouth, MI 48170-2487 · (734) 459-7400 · Fax (734) 459-7403
Phone(734) 459-7400
Fax(734) 459-7403
Sole ProprietorNo
Enumeration DateJune 20, 2006
Last NPPES UpdateApril 29, 2009
✔ NPI 1295770394 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MI · 4301082641
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
47500 FFVE MILE ROAD, Plymouth, MI 48170
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Other Names 1

Former Name (1)Dr. Vijaya Kalluri Md

Other Identifiers 3

Medicare ID-Type UnspecifiedOM85450MI
Medicare UPINH89836MI
OtherOH24978MA · Blue Cross Blue Shield Mi

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Vijaya Mamidipaka M.d. 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.

Medicare Billing Reassignment

Medicare enrollment records show Vijaya Mamidipaka reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

State Of Michigan Office Of Financial Management
18 mi
Psychiatric Hospital
8303 PLATT RD
Saline, MI 48176
  • Reassigned Medicare billing, Michigan enrollment
  • 41 clinicians in this Medicare group
NPI 1003859380 (734) 429-2531

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48170 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
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
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.

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 Vijaya Mamidipaka's NPI number?

The NPI number for Vijaya Mamidipaka is 1295770394. It was assigned to this individual provider in the NPPES registry on June 20, 2006. The provider is also known as Dr. Vijaya Kalluri MD.

Where is Vijaya Mamidipaka located?

Vijaya Mamidipaka practices at 47500 Ffve Mile Road, Plymouth, MI 48170. The listed phone number is (734) 459-7400.

What is Vijaya Mamidipaka's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Vijaya Mamidipaka enrolled in Medicare?

Yes. Vijaya Mamidipaka is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Vijaya Mamidipaka's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Vijaya Mamidipaka reassigns Medicare benefits to State Of Michigan Office Of Financial Management (Saline, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Vijaya Mamidipaka's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Vijaya Mamidipaka was last updated on April 29, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.