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KAVITHA PONDURI MD PC
NPI 1336344431
Internal Medicine in Wayne, MI

Active since June 19, 2007CLIA 23D0961584 · Waiver
34659 W MICHIGAN AVE, WAYNE, MI 48184(734) 722-2400(734) 722-1709 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Kavitha Ponduri Md Pc NPPES

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

KAVITHA PONDURI MD PC (NPI 1336344431) is a healthcare organization registered as an internal medicine in Wayne, Michigan and active in the NPI registry since June 2007. The organization holds a CLIA Waiver certificate valid through June 9, 2027 and lists Kavitha Ponduri, President, as its authorized official.

NPPES Registry Identity

NPI1336344431
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameKAVITHA PONDURI MD PC
Location Address34659 W MICHIGAN AVEWayne, MI 48184-1730
Mailing Address34659 W Michigan AveWayne, MI 48184-1730 · (734) 722-2400 · Fax (734) 722-1709
Phone(734) 722-2400
Fax(734) 722-1709
Organization SubpartNo
Authorized OfficialKavitha PonduriPresident · (734) 722-2400
Enumeration DateJune 19, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1336344431 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
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.
34659 W MICHIGAN AVE, Wayne, MI 48184
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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 Blue Cross Blue Shield of Michigan Mutual Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kavitha Ponduri Md Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Kavitha Ponduri MD PC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Sasi Boppana, M.D.
Internal Medicine
NPI 1528053196
34659 W MICHIGAN AVE
Wayne, MI 48184
(734) 722-2400
✔ PECOS✔ Accepts Medicare0.1 mi
Kavitha Ponduri, M.D.
Internal Medicine
NPI 1679568315
34659 W MICHIGAN AVE
Wayne, MI 48184
(734) 722-2400
✔ PECOS✔ Accepts Medicare0.1 mi

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D0961584

Kavitha Ponduri, MD, PC · Wayne, MI
Active · expires Jun 9, 2027
CLIA Number23D0961584
Laboratory TypePhysician Office
Certificate Effective DateJune 10, 2025
Certificate Expiration DateJune 9, 2027
Laboratory DirectorKavitha Ponduri
Laboratory Phone(734) 722-2400
Laboratory LocationKavitha Ponduri, MD, PC34659 W Michigan Avenue, Wayne, MI 48184
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Kavitha Ponduri MD PC's NPI number?

The NPI number for Kavitha Ponduri MD PC is 1336344431. It was assigned to this organization in the NPPES registry on June 19, 2007.

Where is Kavitha Ponduri MD PC located?

Kavitha Ponduri MD PC is located at 34659 W Michigan Ave, Wayne, MI 48184. The listed phone number is (734) 722-2400.

What is Kavitha Ponduri MD PC's specialty?

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

Is Kavitha Ponduri MD PC enrolled in Medicare?

Yes. Kavitha Ponduri MD PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Kavitha Ponduri MD PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Internal Medicine, reassign their Medicare billing to Kavitha Ponduri MD PC. A 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 the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Kavitha Ponduri MD PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D0961584) is associated with this NPI, valid through June 9, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Kavitha Ponduri MD PC accept?

Health plans from Blue Cross Blue Shield of Michigan Mutual Insurance Company list Kavitha Ponduri MD PC 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 Kavitha Ponduri MD PC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.