Active NPI
Revan Maragiri MD PLC
- Internal Medicine Physician
- Bay City, MI
National Provider Identifier
1003143835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 4301055673
- Legal business name
- REVAN MARAGIRI MD PLC
- Practice address
- 3720 Katalin CT
Bay City, MI 48706-2160 - Phone
- (989) 415-0358
- NPI assigned
- Nov 16, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Revanasiddappa N Maragiri, MD
- Title
- Doctor
- Phone
- (989) 415-0358
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 4301055673 | MI | Primary |
Addresses
Primary practice location
3720 Katalin CT
Bay City, MI 48706-2160
Mailing address
3720 Katalin CT
Bay City, MI 48706-2160
Phone (989) 415-0358
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100109000166 | MI | Part B Supplier - Clinic/Group Practice | 0749321982 |
Receives reassigned benefits from 5 practitioners Practice locations: Bay City, MI |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1258329600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1258329600000",
"number": "1003143835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3720 KATALIN CT",
"city": "BAY CITY",
"state": "MI",
"postal_code": "487062160",
"telephone_number": "989-415-0358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3720 KATALIN CT",
"city": "BAY CITY",
"state": "MI",
"postal_code": "487062160",
"telephone_number": "989-415-0358"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "REVAN MARAGIRI MD PLC",
"organizational_subpart": "NO",
"enumeration_date": "2009-11-16",
"last_updated": "2009-11-16",
"status": "A",
"authorized_official_last_name": "MARAGIRI",
"authorized_official_first_name": "REVANASIDDAPPA",
"authorized_official_middle_name": "N",
"authorized_official_title_or_position": "DOCTOR",
"authorized_official_telephone_number": "989-415-0358",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "MI",
"license": "4301055673",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bay City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.