DR. VISALA DANDAMUDI (M.D.) – Psychiatry Physician, NPI 1982632691

DR. VISALA DANDAMUDI (M.D.) is a healthcare provider. based in Roseville, Michigan. specializing in PSYCHIATRY. They hold the professional credentials M.D.. They hold a License No. 4301080937 (MI). The NPI Number for DR. VISALA DANDAMUDI (M.D.) is 1982632691

Main info

Female
32 Years Of Experience
Accepts Medicare Assignment
Name
DR. VISALA DANDAMUDI (M.D.)
NPI
1982632691
Phone
(586) 773-6020
Address
25869 KELLY RD
Enumeration Date
29 June 2006
Last Update Date
1 April 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8102252506
Graduation Year
1994 (32 years ago)
PAC ID
3173513140
Group Practice PAC ID
2668466996
Professional Enrollment ID
I20040513000530
Address ID
MI481168506BR12851RDXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,216 PSYCHIATRY in MI

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Provider Addresses for DR. VISALA DANDAMUDI (M.D.)

  • 25869, Kelly Road, Roseville, Macomb County, Michigan, 48066, United States

    SUITE A

    ROSEVILLE, MI 480664997

    Phone: (586) 773-6020

    Fax: (586) 773-6093

    Mailing address matches the actual address.

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: 2004-05-13

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
I20040513000530IPsychiatryMITBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90792Psychiatric diagnostic evaluation with medical services1716$0
View full utilization report →

Insurance plans in this area (ZIP 48066)

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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: 2668466996View full group profile
NameSpecialtyState
-MI
Clinical Social WorkerMI
-MI
Family PracticeMI
Mental Health CounselorMI
-MI
Family Practice, Addiction MedicineMI
-MI
Clinical Social WorkerMI
-MI

Reviews

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Frequently asked questions

How do I look up DR. VISALA DANDAMUDI (M.D.) by NPI?
Use NPI 1982632691 when you need to reference DR. VISALA DANDAMUDI (M.D.) in forms, claims, or directories.
Is DR. VISALA DANDAMUDI (M.D.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does DR. VISALA DANDAMUDI (M.D.) work in?
You can think of DR. VISALA DANDAMUDI (M.D.) as practicing within Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Where is DR. VISALA DANDAMUDI (M.D.)'s primary listing?
We display Roseville, Michigan because that is what the record indicates for DR. VISALA DANDAMUDI (M.D.).
Is DR. VISALA DANDAMUDI (M.D.) a real provider?
This page reflects official NPPES data for NPI 1982632691. Always confirm identity and privileges with the practice and licensing boards.

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