DR. VASUDEVARAO MANDAVA (M.D) – Internal Medicine Physician, NPI 1073501821

DR. VASUDEVARAO MANDAVA (M.D) is a healthcare provider. based in Center line, Michigan. specializing in Internal Medicine Physician. They hold the professional credentials M.D. They hold a License No. VM031566 (MI). The NPI Number for DR. VASUDEVARAO MANDAVA (M.D) is 1073501821

Main info

Male
59 Years Of Experience
Accepts Medicare Assignment
Name
DR. VASUDEVARAO MANDAVA (M.D)
NPI
1073501821
Phone
(586) 619-9986
Address
6800 E 10 MILE RD
Enumeration Date
6 October 2005
Last Update Date
24 September 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5867832222
Graduation Year
1967 (59 years ago)
PAC ID
5092899013
Group Practice PAC ID
6406039403
Professional Enrollment ID
I20080228000400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for DR. VASUDEVARAO MANDAVA (M.D)

  • 6800, East 10 Mile Road, Center Line, Macomb County, Michigan, 48015, United States

    CENTER LINE, MI 480151167

    Phone: (586) 619-9986

    Type: Mailing

  • 18, Market Street, Mount Clemens Downtown Loop, Mount Clemens, Macomb County, Michigan, 48043, United States

    SUITE C

    MOUNT CLEMENS, MI 48043

    Phone: (586) 783-2222

    Fax: (586) 783-6280

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $124.

Total Amount is formed as General ($124) + Research ($0) + Ownership ($0) = $124.

Last reported payment date: 2024-08-15 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($124).

Total Amount

$124

General + Research + Ownership

Payments

1

Total payment records

General Amount

$124

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-15

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-02-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20080228000400IInternal MedicineMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48015)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6406039403View full group profile

Reviews

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Frequently asked questions

Can I verify DR. VASUDEVARAO MANDAVA (M.D) with an NPI only?
You can start verification with NPI 1073501821 for DR. VASUDEVARAO MANDAVA (M.D), then check state licensing separately.
Is DR. VASUDEVARAO MANDAVA (M.D) still practicing?
DR. VASUDEVARAO MANDAVA (M.D) is currently listed as active in the public NPI registry.
What is DR. VASUDEVARAO MANDAVA (M.D)'s specialty?
The listing groups DR. VASUDEVARAO MANDAVA (M.D) with Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Does DR. VASUDEVARAO MANDAVA (M.D) list a practice location?
Patients near Center Line, Michigan may find DR. VASUDEVARAO MANDAVA (M.D) in results; validate coverage separately.
Why does DR. VASUDEVARAO MANDAVA (M.D) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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