Individual provider Active NPI

Ravi Raja Kumar Vinnakota, M.D.

  • Internal Medicine Physician
  • Paoli, PA
National Provider Identifier
1245561240
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD455870 Issued in PA
Practice address
255 W Lancaster Ave
Paoli, PA 19301-1763
Phone
(484) 565-1510
NPI assigned
Jan 15, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD455870 PA Primary
Hospitalist Physician 208M00000X MD455870 PA

Addresses

Primary practice location

255 W Lancaster Ave
Paoli, PA 19301-1763

Mailing address

255 W Lancaster Ave
Paoli, PA 19301-1763
Phone (484) 565-1510

Other practice location 1

41 Castle Point Rd
Wappingers Falls, NY 12590-7004
Phone (914) 309-1172

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20161027000395 PA Practitioner - Internal MedicinePractitioner - Hospitalist 9133407091 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
New York Medical College, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

100 E Lancaster Ave
Wynewood, PA 19096-3450

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121

130 S Bryn Mawr Ave H
321 GVH Hospital Medical Services Bryn
Bryn Mawr, PA 19010-3121
Phone (484) 337-4097

255 W Lancaster Ave
Paoli, PA 19301-1763

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD455870PAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare Internal Medicine CurrentSince Sep 18, 2023 Accepting new patients
St Luke's Physician Group Inc CurrentSince Jan 22, 2017 Accepting new patients
St. Luke's Physician Group, Inc. CurrentSince Jan 22, 2017 Accepting new patients
Gslpg, Inc CurrentSince Sep 1, 2021 Accepting new patients
St. Luke's Physician Group, Inc. Current Accepting new patients
Main Line Hospitals, Inc. Past Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

3803 West Chester Pike
Ste 160
Newtown Square, PA 19073
Phone (484) 337-1530

100 Paramount Blvd
Orwigsburg, PA 17961
Phone (272) 639-1000

255 W Lancaster Ave
Paoli, PA 19301
Phone (484) 337-4286

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

Interoperability endpoints

  • Direct secure messaging: ravi.vinnakota@slpg.direct-sluhn.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1263513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1245561240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W LANCASTER AVE",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011763",
            "telephone_number": "484-565-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W LANCASTER AVE",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011763",
            "telephone_number": "484-565-1510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Castle Point Rd",
            "address_purpose": "LOCATION",
            "city": "Wappingers Falls",
            "state": "NY",
            "postal_code": "125907004",
            "country_code": "US",
            "telephone_number": "914-309-1172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VINNAKOTA",
        "first_name": "RAVI",
        "middle_name": "RAJA KUMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-15",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD455870",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "MD455870",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paoli, PA

Sources for this page

Verify at the official NPI Registry.