NPIMap

Individual provider Active NPI

Naveen Prasad Gopalakrishnan Ravikumar, M.D.

  • Nephrology Physician
  • Yakima, WA
National Provider Identifier
1063945368
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD61207757 Issued in WA
Practice address
315 Holton Ave.
Suite 100
Yakima, WA 98902-3245
Phone
(509) 248-6292
Fax
(509) 248-9134
NPI assigned
Apr 4, 2017
Last updated
Aug 12, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Nephrology Physician 207RN0300X MD61207757 WA Primary

Addresses

Primary practice location

315 Holton Ave.
Suite 100
Yakima, WA 98902-3245

Mailing address

315 Holton Ave.
Suite 100
Yakima, WA 98902-3245
Phone (509) 248-6292

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220906000992 WA Practitioner - Nephrology 2567888936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
J. Hamilton Licht, M.D., P.C.Group PAC ID 0648202242, 3 clinicians

Practice addresses (Care Compare)

315 Holton Ave
Suite 100
Yakima, WA 98902-3245
Phone 5092486292102

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
20.4 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
68.01

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
J. Hamilton Licht, M.D., P.C. Nephrology CurrentSince Jul 1, 2022 Accepting new patients
Karen L. Harrison, M.D. P.S., Inc. Nephrology PastSince Jul 1, 2022 Accepting new patients

Locations

315 Holton Ave
Ste 100
Yakima, WA 98902
Phone (509) 248-6292

Interoperability endpoints

  • Direct secure messaging: nravikumar773190@direct.multicare.org

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 10

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": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1063945368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 HOLTON AVE.",
            "address_2": "SUITE 100",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023245",
            "telephone_number": "509-248-6292",
            "fax_number": "509-248-9134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 HOLTON AVE.",
            "address_2": "SUITE 100",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023245",
            "telephone_number": "509-248-6292",
            "fax_number": "509-248-9134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOPALAKRISHNAN RAVIKUMAR",
        "first_name": "NAVEEN PRASAD",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-04",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WA",
            "license": "MD61207757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.