ST CLAIR PULMONARY & CRITICAL CARE P C – Pulmonary Disease Physician, NPI 1710909478

ST CLAIR PULMONARY & CRITICAL CARE P C is a healthcare provider. based in Port huron, Michigan. specializing in Pulmonary Disease Physician. The NPI Number for ST CLAIR PULMONARY & CRITICAL CARE P C is 1710909478

Main info

Organization
Name
ST CLAIR PULMONARY & CRITICAL CARE P C
NPI
1710909478
Phone
(810) 984-8470
Address
1210 10TH AVE
Authorized Official
PODDUTURU SRIDHAR REDDY PRESIDENT MD, MPH
Enumeration Date
24 July 2006
Last Update Date
29 December 2020
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness75
Years active:19State licenses:0Digital endpointsOther names

Provider Addresses for ST CLAIR PULMONARY & CRITICAL CARE P C

  • 1210, 10th Avenue, Port Huron, Saint Clair County, Michigan, 48060, United States

    PORT HURON, MI 480603406

    Phone: (810) 984-8470

    Fax: (810) 984-3919

    Type: Mailing

  • 1210 10th Ave

    Port Huron, MI 480603406

    Phone: (810) 984-8470

    Fax: (810) 984-3919

    Type: Location

  • 2615 ELECTRIC AVE

    PORT HURON, MI 480606575

    Phone: (810) 990-8222

    Fax: (810) 937-5592

    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: 2007-02-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2026-03-31 (73 days ago).

Enrollment records

1

Earliest due date

2026-03-31

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
O20070214000204OClinic/Group PracticeMI2026-03-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

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 48060)

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Reviews

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Frequently asked questions

What unique ID ties claims to ST CLAIR PULMONARY & CRITICAL CARE P C?
NPI 1710909478 is assigned to ST CLAIR PULMONARY & CRITICAL CARE P C under the national enumeration system.
Is ST CLAIR PULMONARY & CRITICAL CARE P C's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does ST CLAIR PULMONARY & CRITICAL CARE P C list a primary specialty?
If you are matching referrals, note Pulmonary Disease Physician for ST CLAIR PULMONARY & CRITICAL CARE P C. Clinical services aligned with this taxonomy classification.
Does ST CLAIR PULMONARY & CRITICAL CARE P C practice in Michigan?
You will see Port Huron, Michigan on file for ST CLAIR PULMONARY & CRITICAL CARE P C alongside any extra practice locations.
Is ST CLAIR PULMONARY & CRITICAL CARE P C a real provider?
This page reflects official NPPES data for NPI 1710909478. Always confirm identity and privileges with the practice and licensing boards.

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