Periakaruppan Ramanathan, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Practice address

2535 Bethany Road
#110
Sycamore, IL 60178

Phone

(815) 756-1434

Fax

(815) 756-4776

NPI assigned

Sep 20, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• P R Ramanathan Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 19, 2016 through Feb 19, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Dekalb Medical Clinic,Inc

  dba Dekalb Internal Medicine

  • Internal Medicine Physician
  • Sycamore, IL
  • NPI 1891969549
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235237082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2535 BETHANY ROAD",
            "address_2": "#110",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "60178",
            "telephone_number": "815-756-1434",
            "fax_number": "815-756-4776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2535 BETHANY ROAD",
            "address_2": "#110",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "60178",
            "telephone_number": "815-756-1434",
            "fax_number": "815-756-4776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMANATHAN",
        "first_name": "PERIAKARUPPAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "01900093",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "P",
            "last_name": "RAMANATHAN",
            "middle_name": "R",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Radiant Dermatology, LTD
• Radiologists LTD
• Gina Louise Raimondi, L.C.S.W.
• Winston D Rajendram, M.D.
• Raneem Rajjoub
• Debra A Rasmussen, APRN, CNP
• Cari-Anne Rathbun, RBT
• Rachel Raupp
• Rebound Therapy Center PC
• Rebound Therapy Ceter

• Internal Medicine Physician in Sycamore, IL
• Providers in Sycamore, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.