Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Shivani V Kondagunta, PA-C

Individual provider Physician Assistant · NPI 1306735311

Shivani V Kondagunta, PA-C is a Physician Assistant in Detroit, Michigan. Graduated from Wayne State University School of Medicine in 2025, 1 year ago. Practices with Huron Gastroenterology Associates PC, a 95-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
1
Trained at
Wayne State University School of Medicine
Licensed in
MI
In the registry since
2025
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

259 Mack Ave
Detroit, MI 48201-2427
Phone: (313) 577-1716
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5300 Elliott Dr, Ypsilanti, MI 48197-8632 — (734) 434-6262

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601013554 (MI)

Record details

NPI number1306735311
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 2, 2025
Last updated in NPPESFebruary 27, 2026
Certification dateFebruary 27, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolWAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduated 2025 (1 years in practice)
Group practice Huron Gastroenterology Associates Pc — 95 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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