Individual provider Active NPI

Deepak Ramanathan, M.D.

  • Internal Medicine Physician
  • Jamaica, NY
National Provider Identifier
1306261086
Registry record updated Feb 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
273668-1 Issued in NY
Practice address
14839 Hillside Ave
Jamaica, NY 11435-3330
Phone
(929) 777-2234
Fax
(718) 744-9728
NPI assigned
Mar 4, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X 273668-1 NY
Internal Medicine Physician 207R00000X 273668-1 NY Primary

Addresses

Primary practice location

14839 Hillside Ave
Jamaica, NY 11435-3330

Mailing address

14839 Hillside Ave
Jamaica, NY 11435-3330
Phone (929) 777-2234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20140729000770 NY Practitioner - Internal Medicine 0749406759 Reassigns benefits to 3 organizations
Practice locations: Jamaica, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Divinity Medical Services PLLCGroup PAC ID 5193030245, 92 clinicians

Practice addresses (Care Compare)

3379 Crompond Rd
Yorktown Heights, NY 10598-3605
Phone (914) 930-5550

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
273668-1NYMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cross Island Medical LLC Multi-Specialty CurrentSince Aug 17, 2021 Accepting new patients
Urgent Care Physician of New York-Hartsdale PLLC Multi-Specialty CurrentSince Sep 30, 2021 Accepting new patients
Divinity Medical Services PLLC Multi-Specialty CurrentSince Jun 1, 2021 Accepting new patients

Locations

13337 41st Ave
Ste A
Flushing, NY 11355
Phone (347) 783-6008

13337 41st Ave
Flushing, NY 11355
Phone (347) 783-6008

3457 82nd St
Ste 1G
Jackson Heights, NY 11372
Phone (718) 424-2457

42 Rockland Plz
Ste 22
Nanuet, NY 10954
Phone (845) 367-7395

3379 Crompond Rd
Yorktown Hts, NY 10598
Phone (914) 245-1111

Networks

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

Organizations & group practices 3

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": "1393891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550534400000",
    "number": "1306261086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14839 HILLSIDE AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114353330",
            "telephone_number": "929-777-2234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14839 HILLSIDE AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114353330",
            "telephone_number": "929-777-2234",
            "fax_number": "718-744-9728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMANATHAN",
        "first_name": "DEEPAK",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-04",
        "last_updated": "2019-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "NY",
            "license": "273668-1",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "273668-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.