Organization Active NPI

Ram V.Rayasam.M.D.P.a

  • Clinic/Center
  • Phillipsburg, NJ
National Provider Identifier
1295724938
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
MA38051 Issued in NJ
Legal business name
RAM V.RAYASAM.M.D.P.A
Practice address
207 S 2ND St
Morrispark
Phillipsburg, NJ 08865-1807
Phone
(908) 454-2279
Fax
(908) 454-5404
NPI assigned
Oct 16, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Ramakumar Venkata Rayasam, M.D.,NPI 1922097666
Title
President
Phone
(908) 454-2279

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X MA38051 NJ Primary

Addresses

Primary practice location

207 S 2ND St
Morrispark
Phillipsburg, NJ 08865-1807

Mailing address

207 S 2ND St
Morrispark
Phillipsburg, NJ 08865-1807
Phone (908) 454-2279

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100608000567 NJ Part B Supplier - Clinic/Group Practice 9133259724 Receives reassigned benefits from 1 practitioner
Practice locations: Phillipsburg, NJ

National Provider Directory

National Provider Directory

Locations

207 S 2nd St
Phillipsburg, NJ 08865
Phone (908) 454-2279

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1129420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295724938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 S 2ND ST",
            "address_2": "MORRISPARK",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088651807",
            "telephone_number": "908-454-2279",
            "fax_number": "908-454-5404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 S 2ND ST",
            "address_2": "MORRISPARK",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088651807",
            "telephone_number": "908-454-2279",
            "fax_number": "908-454-5404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAM V.RAYASAM.M.D.P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RAYASAM",
        "authorized_official_first_name": "RAMAKUMAR",
        "authorized_official_middle_name": "VENKATA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "908-454-2279",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D.,"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NJ",
            "license": "MA38051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phillipsburg, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.