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SHIVASHANKAR SUNDAR KODUVAYUR
NPI 1962349795
Student in an Organized Health Care Education/Training Program in Pontiac, MI

Active since April 30, 2026PECOS Enrolled
50 N PERRY ST, PONTIAC, MI 48342(248) 338-5300 Get Directions Write a Review

NPPES record last updated: April 30, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shivashankar Sundar Koduvayur NPPES

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

SHIVASHANKAR SUNDAR KODUVAYUR (NPI 1962349795) is an individual student in an organized health care education/training program in Pontiac, Michigan and active in the NPI registry since April 2026. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1962349795
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameSHIVASHANKAR SUNDAR KODUVAYUR
Location Address50 N PERRY STPontiac, MI 48342-2217
Mailing Address50 N Perry StPontiac, MI 48342-2217 · (248) 338-5300
Phone(248) 338-5300
Sole ProprietorNo
Enumeration DateApril 30, 2026
NPPES CertifiedApril 30, 2026
✔ NPI 1962349795 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
50 N PERRY ST, Pontiac, MI 48342
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shivashankar Sundar Koduvayur 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.

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.

THAMILARASI SUBRAMANIAN
Physical Therapist
50 N PERRY ST
PONTIAC, MI 48342
Oakland County (248) 338-5000
DR. CORY ERIC MANOOGIAN DO
Psychiatry & Neurology (Psychiatry)
50 N PERRY ST
PONTIAC, MI 48342
Oakland County (248) 384-8130
DR. ESSA HANNA HATTAR MD
Family Medicine
50 N PERRY ST
PONTIAC, MI 48342
Oakland County (248) 338-5392
IMPACT ACO BILLING COMPANY LLC
Internal Medicine
50 N PERRY ST
PONTIAC, MI 48342
Oakland County (248) 338-5516
ANDREW CHARLES ABIRAGI
Student in an Organized Health Care Education/Training Program
50 N PERRY ST
PONTIAC, MI 48342
Oakland County (248) 338-5300
MARTIN ANTONIO RIVERA
Student in an Organized Health Care Education/Training Program
50 N PERRY ST
PONTIAC, MI 48342
Oakland County (248) 338-5000
SHALIN R LASHKARI MSPT
Physical Therapist
50 N PERRY ST
PONTIAC, MI 48342
Oakland County (248) 338-5000
DR. MICHAEL CHRISTOPHER DETTLOFF D.O.
Emergency Medicine
50 N PERRY ST
PONTIAC, MI 48342
Oakland County (248) 338-5000

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 Shivashankar Koduvayur's NPI number?

The NPI number for Shivashankar Koduvayur is 1962349795. It was assigned to this individual provider in the NPPES registry on April 30, 2026.

Where is Shivashankar Koduvayur located?

Shivashankar Koduvayur practices at 50 N Perry St, Pontiac, MI 48342. The listed phone number is (248) 338-5300.

What is Shivashankar Koduvayur's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Shivashankar Koduvayur enrolled in Medicare?

Yes. Shivashankar Koduvayur is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shivashankar Koduvayur was last updated on April 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.