Individual provider Active NPI

Ravin Defonseka, MD

  • Internal Medicine Physician
  • Stamford, CT
National Provider Identifier
1205413085
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DR.0073481 Issued in CO
Practice address
1 Hospital PLZ
Stamford, CT 06902-3602
Phone
(203) 276-7147
NPI assigned
Mar 26, 2021
Last updated
Aug 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DR.0073481 CO Primary

Addresses

Primary practice location

1 Hospital PLZ
Stamford, CT 06902-3602

Mailing address

1 Hospital PLZ
Stamford, CT 06902-3602
Phone (203) 276-7147

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20240826001169 CO Practitioner - Internal Medicine 0244779080 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Firstdoc PCGroup PAC ID 2860688975, 13 clinicians
Hospital Medicine Services of Colorado, LLCGroup PAC ID 9133631351, 73 clinicians

Practice addresses (Care Compare)

1690 Meade St
Denver, CO 80204-1552
Phone (970) 391-4303

501 E Hamden Ave
Englewood, CO 80113-2702
Phone (303) 788-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0073481COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Hospitalist Services, PLLC CurrentSince Jul 15, 2024 Accepting new patients
Hospital Medicine Services of Colorado, LLC CurrentSince Jun 1, 2025 Accepting new patients
Firstdoc PC Internal Medicine CurrentSince Jan 1, 2026 Accepting new patients
Colorado Hospitalist Services, PLLC CurrentSince Jul 15, 2024 Accepting new patients
HCA Healthone LLC Past Accepting new patients
Pam Specialty Hospital of Denver LLC Past Accepting new patients

Locations

1690 Meade St
Denver, CO 80204
Phone (303) 264-6819

4567 E 9th Ave
Denver, CO 80220
Phone (303) 302-2121

501 E Hampden Ave
Englewood, CO 80113
Phone (303) 788-5300

615 Fairhurst St
Sterling, CO 80751
Phone (970) 521-0322

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Organizations & group practices 6

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 5

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": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1205413085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL PLZ",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069023602",
            "telephone_number": "203-276-7147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL PLZ",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069023602",
            "telephone_number": "203-276-7147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFONSEKA",
        "first_name": "RAVIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-26",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0073481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.