Individual provider Active NPI

Chidambaram Raman, MD

  • Surgery Physician
  • Ridgewood, NJ
National Provider Identifier
1063408789
Registry record updated Apr 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MA07530000 Issued in NJ
Practice address
1200 E Ridgewood Ave
West Wing, 2ND Floor
Ridgewood, NJ 07450-3957
Phone
(201) 444-4466
Fax
(201) 444-6672
NPI assigned
Sep 27, 2005
Reactivated
Apr 18, 2006
Last updated
Apr 18, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MA07530000 NJ Primary

Addresses

Primary practice location

1200 E Ridgewood Ave
West Wing, 2ND Floor
Ridgewood, NJ 07450-3957

Mailing address

PO Box 283
Ridgewood, NJ 07451-0283
Phone (201) 444-4466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040527000570 NJ Practitioner - General Surgery 0345221156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chidambaram Raman MD LLCGroup PAC ID 0749326304, 2 clinicians

Practice addresses (Care Compare)

1200 E Ridgewood Ave
Ridgewood, NJ 07450-3937

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA07530000NJMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chidambaram Raman MD LLC Surgery CurrentSince Oct 13, 2009 Accepting new patients
Joseph B. Petelin, M.D., Chartered Surgery Past Accepting new patients

Locations

1200 E Ridgewood Ave
Fl 2
Ridgewood, NJ 07450
Phone (201) 444-0868

1200 E Ridgewood Ave
Ste 203
Ridgewood, NJ 07450
Phone (201) 444-4466

Interoperability endpoints

  • Direct secure messaging: craman190145@ahs.direct-ci.com

Organizations & group practices 2

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.

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": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208476800000",
    "number": "1063408789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 283",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074510283",
            "telephone_number": "201-444-4466",
            "fax_number": "201-444-6672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E RIDGEWOOD AVE",
            "address_2": "WEST WING, 2ND FLOOR",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503957",
            "telephone_number": "201-444-4466",
            "fax_number": "201-444-6672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMAN",
        "first_name": "CHIDAMBARAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2008-04-18",
        "deactivation_date": "2006-03-25",
        "reactivation_date": "2006-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "MA07530000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

Verify at the official NPI Registry.