Individual provider Active NPI

Rangassamy Meibalane, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Newburgh, IN
National Provider Identifier
1154431682
Registry record updated Nov 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
01027658A Issued in IN
Practice address
4199 Gateway Blvd
Newburgh, IN 47630-8940
Phone
(812) 842-4280
Fax
(812) 842-4580
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 01027658A IN Primary

Addresses

Primary practice location

4199 Gateway Blvd
Newburgh, IN 47630-8940

Mailing address

PO Box 637273
Cincinnati, OH 45263-7273
Phone (812) 842-4260

Other identifiers 3

IdentifierTypeStateIssuer
200027100MedicaidIN
64750201MedicaidKY
01027658AOtherINLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01027658AINMDNeonatal-Perinatal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1154431682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 637273",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452637273",
            "telephone_number": "812-842-4260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4199 GATEWAY BLVD",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476308940",
            "telephone_number": "812-842-4280",
            "fax_number": "812-842-4580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEIBALANE",
        "first_name": "RANGASSAMY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "IN",
            "license": "01027658A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200027100",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64750201",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "01027658A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.