Organization Active NPI

Neelakantan Ramineni MD, Inc.

  • Internal Medicine Physician
  • San Diego, CA
National Provider Identifier
1184980930
Registry record updated Apr 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A41289 Issued in CA
Legal business name
NEELAKANTAN RAMINENI MD, INC.
Practice address
4537 College Ave
San Diego, CA 92115-4010
Phone
(619) 265-0504
Fax
(619) 265-8358
NPI assigned
Apr 5, 2012
Organization subpart
Yes
Parent organization
YESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 5, 2012

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

Authorized official

Name
Neelakantan Ramineni, M.D.NPI 1881782647
Title
Owner
Phone
(619) 265-0504

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X A41289 CA Primary

Addresses

Primary practice location

4537 College Ave
San Diego, CA 92115-4010

Mailing address

4537 College Ave
San Diego, CA 92115-4010
Phone (619) 265-0504

Other identifiers 1

IdentifierTypeStateIssuer
00A412890MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120425000099 CA Part B Supplier - Clinic/Group Practice 4284811670 Receives reassigned benefits from 1 practitioner
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory
Part of
Neelakantan Ramineni MD

Locations

4537 College Ave
San Diego, CA 92115
Phone (619) 229-1895

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333584000000",
    "number": "1184980930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4537 COLLEGE AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154010",
            "telephone_number": "619-265-0504",
            "fax_number": "619-265-8358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4537 COLLEGE AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154010",
            "telephone_number": "619-265-0504",
            "fax_number": "619-265-8358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEELAKANTAN RAMINENI MD, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "YES",
        "enumeration_date": "2012-04-05",
        "last_updated": "2012-04-05",
        "status": "A",
        "authorized_official_last_name": "RAMINENI",
        "authorized_official_first_name": "NEELAKANTAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-265-0504",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A41289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A412890",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.