Individual provider Active NPI

Daria Ravangard, MD

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1003482621
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
332571 Issued in NY
Practice address
52 W 8TH St
New York, NY 10011-9092
Phone
(212) 466-4848
Fax
(212) 466-4855
NPI assigned
Jun 3, 2021
Last updated
Oct 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 12850 GA
Family Medicine Physician 207Q00000X 332571 NY Primary

Addresses

Primary practice location

52 W 8TH St
New York, NY 10011-9092

Mailing address

52 W 8TH St
New York, NY 10011-9092
Phone (212) 466-4848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241029004478 GA Practitioner - Family Practice 5890197255 Reassigns benefits to 1 organization
I20241113001529 NY Practitioner - Family Practice 5890197255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

52 W 8TH St
New York, NY 10011-9092
Phone (212) 579-8558

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
332571NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians United Urgent Care CurrentSince Aug 1, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai Family Medicine CurrentSince Dec 1, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Dec 1, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

253 Robert C Daniel Jr Pkwy
Ste 1
Augusta, GA 30909
Phone (336) 254-1380

150 E 42nd St
Fl 9
New York, NY 10017
Phone (646) 605-8119

52 W 8th St
New York, NY 10011
Phone (212) 466-4848

55 E 34th St
New York, NY 10016
Phone (212) 252-6131

10901 Stonelake Blvd
Ste 200
Austin, TX 78759
Phone (512) 767-6149

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1003482621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 W 8TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100119092",
            "telephone_number": "212-466-4848",
            "fax_number": "212-466-4855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 W 8TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100119092",
            "telephone_number": "212-466-4848",
            "fax_number": "212-466-4855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVANGARD",
        "first_name": "DARIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-03",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "12850",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "332571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.