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GREAT LAKES PLASTIC AND HAND SURGERY
NPI 1336335785
Plastic Surgery in Portage, MI

Active since September 19, 2007
7971 MOORSBRIDGE RD, PORTAGE, MI 49024(269) 329-2900(269) 329-1408 Get Directions Write a Review

NPPES record last updated: April 17, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Great Lakes Plastic And Hand Surgery NPPES

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

GREAT LAKES PLASTIC AND HAND SURGERY (NPI 1336335785) is a healthcare organization registered as a plastic surgery in Portage, Michigan and active in the NPI registry since September 2007. The organization lists Raghuram G Elluru, Managing Partner, as its authorized official.

NPPES Registry Identity

NPI1336335785
Entity TypeOrganization
Primary Taxonomy208200000X
Legal Business NameGREAT LAKES PLASTIC RECONSTRUCTIVE & HAND SURGERY P C
Location Address7971 MOORSBRIDGE RDPortage, MI 49024-4075
Mailing Address7971 Moorsbridge RdPortage, MI 49024-4075 · (269) 329-2900 · Fax (269) 329-1408
Phone(269) 329-2900
Fax(269) 329-1408
Organization SubpartNo
Authorized OfficialRaghuram G ElluruManaging Partner · (269) 329-2900
Enumeration DateSeptember 19, 2007
Last NPPES UpdateApril 17, 2013
✔ NPI 1336335785 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208200000X
License✔ Licensed in MI · RE07166
Definition
A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.
7971 MOORSBRIDGE RD, Portage, MI 49024
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Other Names 1

Doing Business AsGreat Lakes Plastic And Hand Surgery

Other Identifiers 9

Other1811994841MI · Dr Holley Npi
Medicaid103481443MI
Medicare PIN0M68650MI
Other1629075668MI · Dr Elluru Npi
Medicaid103481390MI
Medicaid103481480MI
Other0C90475MI · Blue Cross/blue Shield
Medicaid103481434MI
Other0A30093MI · Blue Cross/blue Shield

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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.Insurance ›

Other Providers at the Same Location NPPES 11

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

MICHAEL P MASKILL DPM
Podiatrist (Foot & Ankle Surgery)
7971 MOORSBRIDGE RD
PORTAGE, MI 49024
Kalamazoo County (269) 323-2094
CRAIG MICHAEL BRADFIELD OT
Occupational Therapist
7971 MOORSBRIDGE RD
PORTAGE, MI 49024
Kalamazoo County (269) 321-0929
BRYAN LEE HERDER O.T.
Occupational Therapist
7971 MOORSBRIDGE RD
PORTAGE, MI 49024
Kalamazoo County (269) 321-0929
KYLE L PURDUM OT
Occupational Therapist
7971 MOORSBRIDGE RD
PORTAGE, MI 49024
Kalamazoo County (269) 321-0929
DIANA CALDERON OT
Occupational Therapist
7971 MOORSBRIDGE RD
PORTAGE, MI 49024
Kalamazoo County (269) 321-0929
GREAT LAKES HAND THERAPY PC
Occupational Therapist
7971 MOORSBRIDGE RD
PORTAGE, MI 49024
Kalamazoo County (269) 321-0929
DR. RAGHURAM GOP ELLURU M.D., F.A.C.S.
Surgery (Plastic and Reconstructive Surgery)
7971 MOORSBRIDGE RD
PORTAGE, MI 49024
Kalamazoo County (269) 329-2900
SOUTHWEST MICHIGAN PLASTIC AND HAND SURGERY, PC
Plastic Surgery
7971 MOORSBRIDGE RD
PORTAGE, MI 49024
Kalamazoo County (269) 329-2900

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 Great Lakes Plastic Reconstructive & Hand Surgery P C's NPI number?

The NPI number for Great Lakes Plastic Reconstructive & Hand Surgery P C is 1336335785. It was assigned to this organization in the NPPES registry on September 19, 2007. The provider is doing business as Great Lakes Plastic And Hand Surgery.

Where is Great Lakes Plastic Reconstructive & Hand Surgery P C located?

Great Lakes Plastic Reconstructive & Hand Surgery P C is located at 7971 Moorsbridge Rd, Portage, MI 49024. The listed phone number is (269) 329-2900.

What is Great Lakes Plastic Reconstructive & Hand Surgery P C's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

What insurance does Great Lakes Plastic Reconstructive & Hand Surgery P C accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan and Ambetter from Meridian list Great Lakes Plastic Reconstructive & Hand Surgery P C 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.

When was this NPI record last updated?

The NPPES record for Great Lakes Plastic Reconstructive & Hand Surgery P C was last updated on April 17, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.