Individual provider Active NPI

Ravi Teja Pasam, M.D.

  • Hospitalist Physician
  • Dover, NH
National Provider Identifier
1073900312
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
22497 Issued in NH
Practice address
789 Central Ave
Dover, NH 03820-2526
Phone
(603) 740-2503
Fax
(603) 740-2497
NPI assigned
Apr 24, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 22497 NH
Student in an Organized Health Care Education/Training Program 390200000X
Hospitalist Physician 208M00000X 22497 NH Primary

Addresses

Primary practice location

789 Central Ave
Dover, NH 03820-2526

Mailing address

PO Box 412503
Boston, MA 02241-2503
Phone (617) 726-3884

Other practice location 1

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20220815001058 NH Practitioner - Internal MedicinePractitioner - Hospitalist 8921391160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

789 Central Ave
Dover, NH 03820-2526
Phone (603) 740-2503

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22497NHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wentworth Douglass Physician Corporation Hospitalist CurrentSince Aug 15, 2022 Accepting new patients
Wentworth Douglass Physician Corporation CurrentSince Aug 15, 2022 Accepting new patients
Wentworth Douglass Hospital Current Accepting new patients
Wentworth Douglass Hospital Past Accepting new patients

Locations

789 Central Ave
#2
Dover, NH 03820
Phone (603) 740-2503

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

750 Central Ave
Ste Q
Dover, NH 03820
Phone (603) 742-6030

Interoperability endpoints

  • Direct secure messaging: pasam.raviteja.wdh@direct.partners.masshiway.net

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1429833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1073900312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412503",
            "telephone_number": "617-726-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 CENTRAL AVE",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202526",
            "telephone_number": "603-740-2503",
            "fax_number": "603-740-2497"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Lake Ave N",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016550002",
            "country_code": "US",
            "telephone_number": "508-334-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PASAM",
        "first_name": "RAVI TEJA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-24",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NH",
            "license": "22497",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NH",
            "license": "22497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

Verify at the official NPI Registry.