Provider Demographics
NPI:1629211222
Name:ARIKATI, CHYTHANYA KALYANI (MD)
Entity Type:Individual
Prefix:
First Name:CHYTHANYA
Middle Name:KALYANI
Last Name:ARIKATI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14131 MIDWAY RD
Mailing Address - Street 2:SUITE 620
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-3623
Mailing Address - Country:US
Mailing Address - Phone:972-249-0200
Mailing Address - Fax:972-249-0206
Practice Address - Street 1:1300 W TERRELL AVE STE K230
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-3104
Practice Address - Country:US
Practice Address - Phone:817-250-4906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-13
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301087773207R00000X
TXQ4015207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1054779OtherMCLAREN HEALTH PLAN OF MICHIGAN BAYSIDE SITE
MI381908328OtherHCAP
MI1629211222Medicaid
MI700G36110OtherBLUE CROSS TRADITIONAL, TRUST PPO, BLUE PREFERRED, COMMUNITY BLUE,MICHILD
MI176906OtherGREAT LAKES HEALTH PLAN OF MICHIGAN
MI381908328OtherPRIORITY HEALTH
MI55042OtherHEALTHPLAN OF MICHIGAN
MI01020757OtherHEALTHPLUS OF MICHIGAN
MI1054778OtherMCLARENHEALTH PLAN OF MICHIGAN RUFFIN SITE
MI1054780OtherMCLAREN HEALTH PLAN OF MICHIGAN BRIDGEPORT SITE
MI1054781OtherMCLAREN HEALTH PLAN OF MICHIGAN JANES ST SITE
MI1629211222OtherMOLINA HEALTH PLAN OF MICHIGAN
MI1054779OtherMCLAREN HEALTH PLAN OF MICHIGAN BAYSIDE SITE