KANCHANA MALA MADHAVAN (MD) – Psychiatry Physician, NPI 1811996242

KANCHANA MALA MADHAVAN (MD) is a healthcare provider. based in Southfield, Michigan. specializing in PSYCHIATRY. They hold the professional credentials MD. They hold a License No. 4301069988 (MI). The NPI Number for KANCHANA MALA MADHAVAN (MD) is 1811996242

Main info

Female
31 Years Of Experience
Accepts Medicare Assignment
Name
KANCHANA MALA MADHAVAN (MD)
NPI
1811996242
Phone
(248) 746-0342
Address
25925 TELEGRAPH RD
Enumeration Date
19 July 2005
Last Update Date
29 October 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1995 (31 years ago)
PAC ID
8729970363
Group Practice PAC ID
0547178311
Professional Enrollment ID
I20040327000171
Address ID
MI482022608DE2799XBLVD400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,213 PSYCHIATRY in MI

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Provider Addresses for KANCHANA MALA MADHAVAN (MD)

  • Telegraph Road, Southfield, Oakland County, Michigan, 48033, United States

    210

    SOUTHFIELD, MI 480342518

    Phone: (248) 746-0342

    Fax: (248) 746-0308

    Type: Mailing

  • 37595, 7 Mile Road, Livonia, Wayne County, Michigan, 48152, United States

    LIVONIA, MI 481521003

    Phone: (734) 432-6665

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2004-03-27

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
I20040327000171IPsychiatryMITBD

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 48034)

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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: 0547178311View full group profile
NameSpecialtyState
-MI
Gastroenterology, Internal MedicinePA
Certified Registered Nurse Anesthetist (Crna)MI
Clinical Social WorkerMI
-MI
Physician AssistantMI
Qualified AudiologistMI
O P H T H A L M O L O G YMI
-MI
-MI

Reviews

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Frequently asked questions

Can I verify KANCHANA MALA MADHAVAN (MD) with an NPI only?
You can start verification with NPI 1811996242 for KANCHANA MALA MADHAVAN (MD), then check state licensing separately.
Does the file indicate KANCHANA MALA MADHAVAN (MD) is practicing under active NPI?
Directory data currently reports KANCHANA MALA MADHAVAN (MD) as active.
What is KANCHANA MALA MADHAVAN (MD) best known for clinically?
Directory data describes KANCHANA MALA MADHAVAN (MD) with Psychiatry Physician. Clinical services aligned with this taxonomy classification.
What address line appears for KANCHANA MALA MADHAVAN (MD)?
KANCHANA MALA MADHAVAN (MD)'s geographic hint is Southfield, Michigan in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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