Individual provider Active NPI

Ravinder Reddy Cheruku, MD

  • Anesthesiology Physician
  • New York, NY
National Provider Identifier
1265438311
Registry record updated Sep 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
216098-1 Issued in NY
Practice address
100 E 77TH St
New York, NY 10021-1850
Phone
(212) 434-2878
NPI assigned
Jun 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 216098-1 NY Primary

Addresses

Primary practice location

100 E 77TH St
New York, NY 10021-1850

Mailing address

327 Cresthaven LN
Whitestone, NY 11357-1148
Phone (201) 804-2800

Other identifiers 1

IdentifierTypeStateIssuer
02042813MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110503000704 NY Practitioner - Anesthesiology 6800071077 Reassigns benefits to 1 organization
I20180110000604 TX Practitioner - Anesthesiology 6800071077 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
216098-1NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clear Skies Anesthesia PLLC Anesthesiology CurrentSince Jun 1, 2023 Accepting new patients
Endoscopy Center of Long Island LLC CurrentSince Feb 13, 2019 Accepting new patients
Choice Anesthesia Anesthesiology CurrentSince Mar 2, 2024 Accepting new patients
Texas Anesthesia Partners, PLLC Anesthesiology CurrentSince Jul 21, 2022 Accepting new patients

Locations

711 Stewart Ave
Ste 114
Garden City, NY 11530
Phone (516) 227-3254

700 Highlander Blvd
Ste 415
Arlington, TX 76015
Phone (817) 330-1102

10740 N Central Expy
Ste 400
Dallas, TX 75231
Phone (214) 360-0000

8111 Meadow Rd
Dallas, TX 75231
Phone (214) 471-5975

7502 Greenville Ave
Dallas, TX 75231
Phone (469) 221-6000

7115 Greenville Ave
Ste 100
Dallas, TX 75231
Phone (214) 647-5300

3800 Gaylord Pkwy
Ste 410
Frisco, TX 75034
Phone (972) 668-5911

5500 Frisco Square Blvd
Frisco, TX 75034
Phone (214) 618-0500

9955 Gillespie Dr
Ste 200
Plano, TX 75025
Phone (469) 606-0060

2850 E Highway 114
Trophy Club, TX 76262
Phone (817) 837-4600

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536710400000",
    "number": "1265438311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 CRESTHAVEN LN",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113571148",
            "telephone_number": "201-804-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E 77TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100211850",
            "telephone_number": "212-434-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERUKU",
        "first_name": "RAVINDER",
        "middle_name": "REDDY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2018-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "216098-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02042813",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.