Individual provider Active NPI

Pretam Ganesh Rampersaud, MD

  • Gastroenterology Physician
  • Brooklyn, NY
National Provider Identifier
1104816685
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
60210256 Issued in NY
Practice address
705 86TH St
Brooklyn, NY 11228-3232
Phone
(718) 980-9898
Fax
(718) 980-9897
NPI assigned
Oct 25, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 60210256 NY Primary

Addresses

Primary practice location

705 86TH St
Brooklyn, NY 11228-3232

Mailing address

301 Buel Ave
Side Entrance
Staten Island, NY 10305-2201
Phone (718) 980-9898

Other identifiers 8

IdentifierTypeStateIssuer
2499303OtherGHI
059AKOtherEMPIRE BC/BS
3C3783OtherHEALTHNET
2180918OtherUHC
75181319OtherAETNA
02318436MedicaidNY
P2548888OtherOXFORD
144425OtherHIP

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040628000142 NY Practitioner - GastroenterologyPractitioner - Pathology 5092791350 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
State University of New York Downstate Medical Center, 1994
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

457 Alter Ave
Staten Island, NY 10305-2310
Phone (718) 979-9790

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60210256NYMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pretam G Rampersaud MD PC Gastroenterology CurrentSince Nov 1, 2015 Accepting new patients
PGR Gastro LLC CurrentSince Apr 14, 2021 Accepting new patients
Digestive Disease Associates, PC Gastroenterology Past Accepting new patients

Locations

1800 Clove Rd
Ste 2
Staten Island, NY 10304
Phone (718) 979-9790

Interoperability endpoints

  • Direct secure messaging: prampersaud65546@northwell.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104816685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 BUEL AVE",
            "address_2": "SIDE ENTRANCE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103052201",
            "telephone_number": "718-980-9898",
            "fax_number": "718-980-9897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 86TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112283232",
            "telephone_number": "718-980-9898",
            "fax_number": "718-980-9897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMPERSAUD",
        "first_name": "PRETAM",
        "middle_name": "GANESH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "60210256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "2499303",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC/BS",
            "identifier": "059AK",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "3C3783",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "2180918",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "75181319",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02318436",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2548888",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "144425",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.