Individual provider Active NPI

Ram Mohan Rao Venepally, MD

  • Hospitalist Physician
  • Presque Isle, ME
National Provider Identifier
1033368113
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD17919 Issued in ME
Practice address
140 Academy St
Presque Isle, ME 04769-3102
Phone
(207) 768-4412
NPI assigned
Sep 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X MD2014-0612 NM
Hospitalist Physician 208M00000X MD17919 ME Primary

Addresses

Primary practice location

140 Academy St
Presque Isle, ME 04769-3102

Mailing address

140 Academy St
Presque Isle, ME 04769-3102
Phone (207) 768-4412

Other identifiers 1

IdentifierTypeStateIssuer
1033368113MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141029001580 NM Practitioner - HospitalistPractitioner - Internal Medicine 1658430533 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Las Cruces HB Medical Services LLCGroup PAC ID 8123473600, 157 clinicians

Practice addresses (Care Compare)

4311 E Lohman Ave
Las Cruces, NM 88011-8255
Phone (575) 556-7455

Hospital & facility affiliations

  • Mountain View Regional Medical Center Hospital, Las Cruces, NM, CCN 320085

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD17919MEMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riogrande Care Pharmacy LLC CurrentSince Feb 23, 2021 Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc. Current Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc CurrentSince Mar 10, 2018 Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc Family Medicine CurrentSince Mar 10, 2018 Accepting new patients
Las Cruces HB Medical Services LLC Hospitalist CurrentSince Sep 24, 2023 Accepting new patients
Rio Grande Hematology and Oncology, LLC CurrentSince Jan 13, 2020 Accepting new patients
Las Cruces Medical Center LLC Past Accepting new patients

Locations

1901 Red Rock Dr
Gallup, NM 87301
Phone (505) 863-7000

2811 N Main St
Las Cruces, NM 88001
Phone (575) 526-0080

4311 E Lohman Ave
Las Cruces, NM 88011
Phone (505) 556-6800

Organizations & group practices 7

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1033368113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 ACADEMY ST",
            "city": "PRESQUE ISLE",
            "state": "ME",
            "postal_code": "047693102",
            "telephone_number": "207-768-4412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 ACADEMY ST",
            "city": "PRESQUE ISLE",
            "state": "ME",
            "postal_code": "047693102",
            "telephone_number": "207-768-4412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENEPALLY",
        "first_name": "RAM MOHAN",
        "middle_name": "RAO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-15",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NM",
            "license": "MD2014-0612",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "ME",
            "license": "MD17919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033368113",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Presque Isle, ME

Sources for this page

Verify at the official NPI Registry.