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SHIVA SWAROOP BONGU MD
NPI 1467142851
Internal Medicine in Mount Clemens, MI

Active since May 10, 2023PECOS Enrolled
1000 HARRINGTON ST, MOUNT CLEMENS, MI 48043(586) 493-3727 Get Directions Write a Review

NPPES record last updated: May 10, 2023. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Shiva Swaroop Bongu Md NPPES

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

SHIVA SWAROOP BONGU MD (NPI 1467142851) is an individual internal medicine provider in Mount Clemens, Michigan, licensed in Michigan (4351050725) and active in the NPI registry since May 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2026).

NPPES Registry Identity

NPI1467142851
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameSHIVA SWAROOP BONGUCredential: MD
Location Address1000 HARRINGTON STMount Clemens, MI 48043-2920
Mailing Address1000 Harrington StMount Clemens, MI 48043-2920 · (586) 493-3727
Phone(586) 493-3727
Sole ProprietorNo
Medical School CMSOtherGraduated 2026
Enumeration DateMay 10, 2023
NPPES CertifiedMay 10, 2023
✔ NPI 1467142851 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MI · 4351050725
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.
1000 HARRINGTON ST, Mount Clemens, MI 48043
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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, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shiva Swaroop Bongu Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9931555901
PECOS Enrollment IDI20260813001081
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 Shiva Bongu reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Great Lakes Medical Associates, PC
123 mi
Internal Medicine
1021 E. MAIN STREET
Edmore, MI 48829
  • Reassigned Medicare billing, Michigan enrollment
  • 12 clinicians in this Medicare group
NPI 1811094295 (989) 427-5320

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 48043 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.

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.

LEMAR GARDEZI MD
Student in an Organized Health Care Education/Training Program
1000 HARRINGTON ST
MOUNT CLEMENS, MI 48043
Macomb County (586) 493-3727
WILLIAM B HALACOGLU DO PC
Emergency Medicine
1000 HARRINGTON ST
MOUNT CLEMENS, MI 48043
Macomb County (586) 493-8101
JAVIER ZARATE
Nurse Anesthetist, Certified Registered
1000 HARRINGTON ST
MOUNT CLEMENS, MI 48043
Macomb County (586) 493-8000
KRISTIN HOFSTAD PA
Physician Assistant
1000 HARRINGTON ST
MOUNT CLEMENS, MI 48043
Macomb County (586) 493-8000
ANDREA PERRIN DO
Student in an Organized Health Care Education/Training Program
1000 HARRINGTON ST
MOUNT CLEMENS, MI 48043
Macomb County (586) 493-8000
JESSICA JOYCE LUTKENHOFF MD
Student in an Organized Health Care Education/Training Program
1000 HARRINGTON ST
MOUNT CLEMENS, MI 48043
Macomb County (586) 493-8000
ABIRA MUMTAZ
Internal Medicine
1000 HARRINGTON ST
MOUNT CLEMENS, MI 48043
Macomb County (586) 493-8000
MS. LINDSEY APRIL MCCLAIN CRNA
Nurse Anesthetist, Certified Registered
1000 HARRINGTON ST
MOUNT CLEMENS, MI 48043
Macomb County (586) 493-8000

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 Shiva Bongu's NPI number?

The NPI number for Shiva Bongu is 1467142851. It was assigned to this individual provider in the NPPES registry on May 10, 2023.

Where is Shiva Bongu located?

Shiva Bongu practices at 1000 Harrington St, Mount Clemens, MI 48043. The listed phone number is (586) 493-3727.

What is Shiva Bongu's specialty?

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

Is Shiva Bongu enrolled in Medicare?

Yes. Shiva Bongu is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Shiva Bongu's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shiva Bongu reassigns Medicare benefits to Great Lakes Medical Associates, PC (Edmore, 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 Shiva Bongu's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Shiva Bongu accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Oscar Insurance Company list Shiva Bongu 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 Shiva Bongu was last updated on May 10, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.