Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mohan Krishna Bangaru

Individual provider Nephrology Physician · NPI 1275932121

Mohan Krishna Bangaru is a Nephrology in Detroit, Michigan. Qualified in 2009, 17 years ago. Practices with Southwest Kidney Institute PLC, a 100-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
17
Licensed in
MI
In the registry since
2014
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Practice location Address checks out

4201 Saint Antoine St
Detroit, MI 48201-2153
Phone: (313) 745-7145
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 37595 7 Mile Rd, Livonia, MI 48152-1003 — (734) 793-2470

Specialties & licences

Nephrology Physician (primary) Taxonomy 207RN0300X · Licence 4301119098 (MI)

Record details

NPI number1275932121
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 16, 2014
Last updated in NPPESJuly 21, 2022
Mailing address19426 Mayfield Ave Apt 104, Livonia, MI 48152-4203

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNEPHROLOGY
Also practisesINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Southwest Kidney Institute Plc — 100 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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