Individual provider Active NPI

Ramakrishna Gudapati, MD

  • Psychiatry Physician
  • Hackensack, NJ
National Provider Identifier
1275589202
Registry record updated Jul 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
25MA07691100 Issued in NJ
Practice address
310 Prospect Ave Apt 223
Hackensack, NJ 07601-7763
Phone
(201) 880-7484
NPI assigned
May 25, 2006
Last updated
Jul 22, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 25MA07691100 NJ Primary

Addresses

Primary practice location

310 Prospect Ave Apt 223
Hackensack, NJ 07601-7763

Mailing address

310 Prospect Ave Apt 223
Hackensack, NJ 07601-7763
Phone (201) 880-7484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20040928000358 NJ Practitioner - Psychiatry 1052380920 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Immediate Care Psychiatric CenterGroup PAC ID 0042206757, 8 clinicians

Practice addresses (Care Compare)

205 Robin Rd
Suite 115
Paramus, NJ 07652-1415
Phone (201) 984-9373

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ramakrishna Gudapati MD LLC Psychiatry CurrentSince Feb 19, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374451200000",
    "number": "1275589202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 PROSPECT AVE APT 223",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076017763",
            "telephone_number": "201-880-7484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 PROSPECT AVE APT 223",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076017763",
            "telephone_number": "201-880-7484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUDAPATI",
        "first_name": "RAMAKRISHNA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2013-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA07691100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.