Active NPI
Ravichand Madala, M.D.
- Sleep Medicine (Internal Medicine) Physician
- Grand Rapids, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sleep Medicine (Internal Medicine) Physician
- License
- 4301102594
- Practice address
- 4100 Lake Dr SE Ste 200
Grand Rapids, MI 49546-8292 - Phone
- (616) 391-3759
- Fax
- (616) 391-3052
- NPI assigned
- Mar 22, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 35.089399 | OH | |
| Neurology Physician | 2084N0400X | 35089399 | OH | |
| Sleep Medicine (Internal Medicine) Physician | 207RS0012X | 4301102594 | MI | Primary |
Addresses
Primary practice location
4100 Lake Dr SE Ste 200
Grand Rapids, MI 49546-8292
Mailing address
100 Michigan St NE
Mc845
Grand Rapids, MI 49503-2560
Phone (616) 486-6557
Other names 1
- Dr. Ravichand Madala
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Ravichand.Madala@epic00.shdirect.org | ||
| FHIR URL | https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Sleep Medicine
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
100 Michigan Ave NE
Grand Rapids, MI 49503-2560
100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115
2249 Wealthy St SE
110 Corewell Health Medical Group West
East Grand Rapids, MI 49506-3055
Phone (616) 391-4600
225 N State St
Corewell Health Medical Group West
Reed City, MI 49677-1089
Phone (616) 267-2400
4100 Lake Dr SE
Grand Rapids, MI 49546-8292
4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600
602 Michigan Ave
Suite 102
Holland, MI 49423-4918
Phone (616) 494-8724
80 68TH St SE
Grand Rapids, MI 49548-6980
80 68TH St SE FL
1 Corewell Health Medical Group West
Grand Rapids, MI 49548-6980
Phone (616) 267-8950
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35.089399 | OH | MD | Internal Medicine Physician |
| 4301102594 | MI | MD | Sleep Medicine (Internal Medicine) Physician |
| 35089399 | OH | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spectrum Health Primary Care Partners | Internal Medicine | Current | Accepting new patients |
| Spectrum Health Primary Care Partners | Internal Medicine | Current | Accepting new patients |
| Neurology and Neuroscience Associates, Inc. | Sleep Medicine | Past | Accepting new patients |
Locations
705 Oak St
Big Rapids, MI 49307
Phone (231) 592-4356
2249 Wealthy St SE
Ste 110
Grand Rapids, MI 49506
Phone (616) 391-4600
100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242
2750 E Beltline Ave NE
Grand Rapids, MI 49525
Phone (616) 267-7015
4100 Lake Dr SE
Ste 200
Grand Rapids, MI 49546
Phone (616) 267-8244
588 E Lakewood Blvd
Holland, MI 49424
Phone (616) 494-5800
80 68th St SE
Kentwood, MI 49548
Phone (616) 391-8220
4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600
300 N Patterson Rd
Reed City, MI 49677
Phone (231) 832-3271
225 N State St
Reed City, MI 49677
Phone (231) 832-7108
Interoperability endpoints
- rmadala83910@epic00.corewelldirect.org
- ravichand.madala@epic00.shdirect.org
Organizations & group practices 3
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.
-
dba Corewell Health Medical Group West
- Internal Medicine Physician
- Grand Rapids, MI
- NPI 1235188673
-
dba Corewell Health Medical Group West
- Internal Medicine Physician
- Grand Rapids, MI
- NPI 1689499667
-
- Neurology Physician
- Akron, OH
- NPI 1184675720
Sleep Medicine
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Holland Hospital
- General Acute Care Hospital
- Holland, MI
- NPI 1871672618
-
dba Corewell Health Ludington Hospital
- General Acute Care Hospital
- Ludington, MI
- NPI 1972589489
-
dba Corewell Health Pennock Hospital
- Critical Access Hospital
- Hastings, MI
- NPI 1932695525
-
dba Corewell Health Reed City Hospital
- Critical Access Hospital
- Reed City, MI
- NPI 1437259843
-
dba Corewell Health Grand Rapids Hospital
- General Acute Care Hospital
- Grand Rapids, MI
- NPI 1922090554
-
dba Corewell Health Zeeland Hospital
- General Acute Care Hospital
- Zeeland, MI
- NPI 1275536344
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614211200000",
"number": "1083730907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MICHIGAN ST NE",
"address_2": "MC845",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032560",
"telephone_number": "616-486-6557",
"fax_number": "616-486-6702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 LAKE DR SE STE 200",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495468292",
"telephone_number": "616-391-3759",
"fax_number": "616-391-3052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADALA",
"first_name": "RAVICHAND",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-22",
"last_updated": "2021-02-25",
"certification_date": "2021-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OH",
"license": "35.089399",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "OH",
"license": "35089399",
"primary": false
},
{
"code": "207RS0012X",
"taxonomy_group": "",
"desc": "Internal Medicine, Sleep Medicine",
"state": "MI",
"license": "4301102594",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Ravichand.Madala@epic00.shdirect.org",
"affiliation": "N",
"address_1": "4100 Lake Dr SE Ste 200",
"city": "Grand Rapids",
"state": "MI",
"country_code": "US",
"postal_code": "495468292",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "4100 Lake Dr SE Ste 200",
"city": "Grand Rapids",
"state": "MI",
"country_code": "US",
"postal_code": "495468292",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "RAVICHAND",
"last_name": "MADALA",
"prefix": "DR.",
"credential": "M.D.",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.