Tharakaram Ravishankar, MD FACE

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

125628 Issued in NY

Practice address

997 Glen Cove Ave
Glen Head, NY 11545-1593

Phone

(516) 674-9144

Fax

(516) 674-4024

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280102400000",
    "number": "1083709794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "997 GLEN COVE AVE",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "115451593",
            "telephone_number": "516-674-9144",
            "fax_number": "516-674-4024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "997 GLEN COVE AVE",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "115451593",
            "telephone_number": "516-674-9144",
            "fax_number": "516-674-4024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVISHANKAR",
        "first_name": "THARAKARAM",
        "name_prefix": "Dr.",
        "credential": "MD FACE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2010-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "125628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Tamara Portuondo-Smith, NURSE PRACTITIONER
• Purple Table S.L.P., PLLC
• Pamela N Rademacher, LCSW
• Chithkala Ravishankar, MS RD CDE
• Shreyas T Ravishankar, MD
• Reduce Home Falls Inc
• Leslie Reduto, LCSW, CASAC
• Andrea Rettig, MS OTRL
• Lawrence Robinson, M.D.
• Ali Rodriguez

• Endocrinology, Diabetes & Metabolism Physician in Glen Head, NY
• Providers in Glen Head, NY by specialty
• Endocrinology, Diabetes & Metabolism Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.