Individual provider Active NPI

Raman Puri, M.D.

  • Internal Medicine Physician
  • Columbia, MO
National Provider Identifier
1295756906
Registry record updated Nov 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2000171135 Issued in MO
Practice address
2475 Broadway Bluffs Drive
Ste. 301
Columbia, MO 65201-8128
Phone
(573) 874-3235
Fax
(573) 817-5917
NPI assigned
Jul 21, 2006
Last updated
Nov 16, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2000171135 MO Primary

Addresses

Primary practice location

2475 Broadway Bluffs Drive
Ste. 301
Columbia, MO 65201-8128

Mailing address

2475 Broadway Bluffs Drive
Ste. 301
Columbia, MO 65201-8128
Phone (573) 874-3235

Other identifiers 1

IdentifierTypeStateIssuer
205204506MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20100827000933 MO Practitioner - Internal Medicine 8527115724 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Missouri, Columbia School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2475 Broadway Bluffs Dr
Suite 301
Columbia, MO 65201-8147
Phone (573) 874-3235

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Hospitality Inc. Internal Medicine CurrentSince May 1, 2002 Accepting new patients

Locations

1601 E Broadway
Ste 240
Columbia, MO 65201
Phone (573) 815-8145

2475 Broadway Bluffs Dr
Ste 301
Columbia, MO 65201
Phone (573) 874-3235

Organizations & group practices 1

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.

Hospital & facility affiliations 6

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353024000000",
    "number": "1295756906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2475 BROADWAY BLUFFS DRIVE",
            "address_2": "STE. 301",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018128",
            "telephone_number": "573-874-3235",
            "fax_number": "573-817-5917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2475 BROADWAY BLUFFS DRIVE",
            "address_2": "STE. 301",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018128",
            "telephone_number": "573-874-3235",
            "fax_number": "573-817-5917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURI",
        "first_name": "RAMAN",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2012-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2000171135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205204506",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.