Individual provider Active NPI

Ravichand Madala, M.D.

  • Sleep Medicine (Internal Medicine) Physician
  • Grand Rapids, MI
National Provider Identifier
1083730907
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X
License
4301102594 Issued in MI
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

Updated by the provider on Feb 25, 2021

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 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 Professional name

Electronic endpoints 2

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131008000656 MI Practitioner - Sleep MedicinePractitioner - Internal MedicinePractitioner - NeurologyPractitioner - Other (Physician) 9537337845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sleep MedicineAlso: Neurology
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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.089399OHMDInternal Medicine Physician
4301102594MIMDSleep Medicine (Internal Medicine) Physician
35089399OHMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners Internal Medicine CurrentSince Aug 19, 2013 Accepting new patients
Spectrum Health Primary Care Partners Internal Medicine CurrentSince Aug 19, 2013 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

  • Direct secure messaging: rmadala83910@epic00.corewelldirect.org
  • Direct secure messaging: 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.

Hospital & facility affiliations 6

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": "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

Verify at the official NPI Registry.