NPIMap

Individual provider Active NPI

Lea Grace Ramos Famularcano, MD

  • Family Medicine Physician
  • Hurricane, WV
National Provider Identifier
1174790729
Registry record updated Jan 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
24101 Issued in WV
Practice address
1041 Hospital Drive
Suite 306
Hurricane, WV 25526
Phone
(304) 397-5744
Fax
(304) 757-0964
NPI assigned
May 13, 2008
Last updated
Jan 19, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 24101 WV Primary

Addresses

Primary practice location

1041 Hospital Drive
Suite 306
Hurricane, WV 25526

Mailing address

4111 1St Ave
Ste 3
Nitro, WV 25143-1345
Phone (304) 397-5744

Other identifiers 1

IdentifierTypeStateIssuer
24101OtherWVSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100917000579 WV Practitioner - Family Practice 5193840940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-5432

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. CurrentSince Jan 1, 2017 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Jan 1, 2017 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients

Locations

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

1400 Hospital Dr
Hurricane, WV 25526
Phone (304) 757-1700

1401 Hospital Dr
Ste 306
Hurricane, WV 25526
Phone (304) 397-5744

4111 1st Ave
Ste 3
Nitro, WV 25143
Phone (304) 755-4797

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484784000000",
    "number": "1174790729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 1ST AVE",
            "address_2": "STE 3",
            "city": "NITRO",
            "state": "WV",
            "postal_code": "251431345",
            "telephone_number": "304-397-5744",
            "fax_number": "304-757-0964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 HOSPITAL DRIVE",
            "address_2": "SUITE 306",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "25526",
            "telephone_number": "304-397-5744",
            "fax_number": "304-757-0964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAMULARCANO",
        "first_name": "LEA GRACE",
        "middle_name": "RAMOS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-13",
        "last_updated": "2017-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "24101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "24101",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hurricane, WV

Sources for this page

Verify at the official NPI Registry.