Ravi Tej Bommu, MD
Individual provider Active NPI Medical Microbiology Physician · Iowa City, IA
NPI 1164085049 · NPPES record last updated Oct 17, 2025
Key facts
- NPI
- 1164085049
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Microbiology Physician 207ZM0300X
- License
- MD-54997 (IA)
- Practice address
- 200 Hawkins Dr
Iowa City, IA 52242-1009 - Phone
- (319) 384-9609
- Fax
- (319) 356-2987
- NPI assigned
- Apr 17, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 21
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Pathology
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- State University of Iowa
Practice addresses (Care Compare)
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-1616
Hospital & facility affiliations
- University of Iowa Hospital & Clinics
- University of Iowa Health Care Medical Center Down
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251024000657 | IA | Practitioner - Pathology | 9537494406 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD-54997 | IA | MD | Medical Microbiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State University of Iowa | Current |
Accepting new patients |
Locations
200 Hawkins Dr
#C660
Iowa City, IA 52242
Phone (319) 356-2991
200 Hawkins Dr
#H
Iowa City, IA 52242
Phone (319) 356-1616
200 Hawkins Dr
Iowa City, IA 52242
Phone (319) 356-1616
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Microbiology Physician | 207ZM0300X | MD-54997 | IA | Yes |
Addresses
Primary practice location
200 Hawkins Dr
Iowa City, IA 52242-1009
Mailing address
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 384-9609
NPI Registry JSON
{
"created_epoch": "1555459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760659200000",
"number": "1164085049",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 HAWKINS DR",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522421009",
"telephone_number": "319-384-9609",
"fax_number": "319-356-2987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 HAWKINS DR",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522421009",
"telephone_number": "319-384-9609",
"fax_number": "319-356-2987"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOMMU",
"first_name": "RAVI TEJ",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-17",
"last_updated": "2025-10-17",
"certification_date": "2025-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "207ZM0300X",
"taxonomy_group": "",
"desc": "Pathology, Medical Microbiology",
"state": "IA",
"license": "MD-54997",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Iowa City, IA
- Holly-Marie Bolger
- Matthew John Bollier
- Kimberly Jane Bolton
- Timothy Jerome Boly
- Hannah Bombei
- Carson Ann Bomstad
- Farrah Bonde
- Ruth Bondurant
- Kale Stephen Bongers
- Jaime Bonner
All providers in Iowa City, IA · Medical Microbiology Physician in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.