VISWANATHA R MUKKAMALLA PHYSICAL THERAPIST
NPI 1629572805
Physical Therapist in Southfield, MI

Active since March 21, 2018
17220 W 12 MILE RD STE 140, SOUTHFIELD, MI 48076(248) 281-3428(248) 281-3478 Get Directions Write a Review

NPPES record last updated: June 1, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 1, 2021, Mar 21, 2018 (2 updates tracked since 2018).

About Viswanatha R Mukkamalla Physical Therapist NPPES

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

VISWANATHA R MUKKAMALLA PHYSICAL THERAPIST (NPI 1629572805) is an individual physical therapist in Southfield, Michigan, licensed in Michigan (5501013960) and active in the NPI registry since March 2018. He maintains 2 additional practice locations.

NPPES Registry Identity

NPI1629572805
Entity TypeIndividualMale
Primary Taxonomy225100000X
Provider Legal NameVISWANATHA R MUKKAMALLACredential: PHYSICAL THERAPIST
Location Address17220 W 12 MILE RD STE 140Southfield, MI 48076-2114
Mailing Address41667 Steinbeck GlnNovi, MI 48377-2869
Fax(248) 281-3478
Sole ProprietorNo
Enumeration DateMarch 21, 2018
Last NPPES UpdateJune 1, 20222 updates tracked since enumeration
NPPES CertifiedJune 1, 2022
✔ NPI 1629572805 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
License✔ Licensed in MI · 5501013960
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
17220 W 12 MILE RD STE 140, Southfield, MI 48076

Secondary Practice Locations 2

Location 121017 Middlebelt RdFarmington Hills, MI 48336-5547 · Phone (248) 476-8300
Location 26535 Drake RdWest Bloomfield, MI 48322-3147 · Phone (248) 592-2000 ext. 1720

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Viswanatha R Mukkamalla Physical Therapist is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignments

3

Medicare enrollment records show Viswanatha Mukkamalla reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Physical Therapist
17220 W 12 MILE RD # 140
Southfield, MI 48076
  • Reassigned Medicare billing, Michigan enrollment
  • 4 clinicians in this Medicare group
Physical Therapist
6495 SHILOH RD, SUITE 100
Alpharetta, GA 30005
  • Reassigned Medicare billing, Georgia enrollment
  • 7 clinicians in this Medicare group
Physical Therapist
260 PEACHTREE ST NW STE 2200
Atlanta, GA 30303
  • Reassigned Medicare billing, Georgia enrollment
  • 323 clinicians in this Medicare group

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

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 Viswanatha Mukkamalla's NPI number?

The NPI number for Viswanatha Mukkamalla is 1629572805. It was assigned to this individual provider in the NPPES registry on March 21, 2018.

Where is Viswanatha Mukkamalla located?

Viswanatha Mukkamalla practices at 17220 W 12 Mile Rd Ste 140, Southfield, MI 48076. The listed phone number is (248) 281-3428.

What is Viswanatha Mukkamalla's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Viswanatha Mukkamalla enrolled in Medicare?

Yes. Viswanatha Mukkamalla is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Viswanatha Mukkamalla's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Viswanatha Mukkamalla reassigns Medicare benefits to 3 organizations: We Care Physical Therapy (Southfield, MI), Georgia Physical Therapy & Sports Medicine Center (Alpharetta, GA) and Georgia Luna Care Physical Therapy LLC (Atlanta, GA). Each 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 Viswanatha Mukkamalla's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Viswanatha Mukkamalla accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Oscar Health list Viswanatha Mukkamalla 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 Viswanatha Mukkamalla was last updated on June 1, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.