Individual provider Active NPI

Madhavi L Ravipati, M.D.

  • Obstetrics & Gynecology Physician
  • Stockton, CA
National Provider Identifier
1124227632
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A98168 Issued in CA
Practice address
1617 N California St
Suite 2-a
Stockton, CA 95204-6117
Phone
(209) 466-8546
Fax
(209) 466-3335
NPI assigned
Jul 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A98168 CA
Obstetrics & Gynecology Physician 207V00000X A98168 CA Primary

Addresses

Primary practice location

1617 N California St
Suite 2-a
Stockton, CA 95204-6117

Mailing address

PO Box 1090
Lodi, CA 95241-1090
Phone (209) 334-1800

Other identifiers 2

IdentifierTypeStateIssuer
1386636165OtherCAGROUP NPI
00A981680MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20071009000869 CA Practitioner - Obstetrics/Gynecology 6901992718 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A98168CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Obstetrics & Gynecology CurrentSince Jan 2, 2011 Accepting new patients
Permanente Medical Group, Inc CurrentSince Jan 2, 2011 Accepting new patients
Permanente Medical Group Inc Obstetrics & Gynecology Current Accepting new patients

Locations

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

2185 W Grant Line Rd
Tracy, CA 95377
Phone (209) 839-3200

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

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": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1124227632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1090",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952411090",
            "telephone_number": "209-334-1800",
            "fax_number": "209-334-1430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 N CALIFORNIA ST",
            "address_2": "SUITE 2-A",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046117",
            "telephone_number": "209-466-8546",
            "fax_number": "209-466-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVIPATI",
        "first_name": "MADHAVI",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-13",
        "last_updated": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A98168",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A98168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1386636165",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A981680",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2185 W Grant Line Rd",
            "city": "Tracy",
            "state": "CA",
            "country_code": "US",
            "postal_code": "953777309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.