NPIMap

Individual provider Active NPI

Yellamraju Ravi Kumar, M.D.

  • Internal Medicine Physician
  • Alden, NY
National Provider Identifier
1326004649
Registry record updated Mar 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
225749 Issued in NY
Practice address
12845 Broadway
Alden, NY 14004-1223
Phone
(716) 937-3255
Fax
(716) 204-7481
NPI assigned
Apr 25, 2006
Last updated
Mar 29, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 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 225749 NY Primary

Addresses

Primary practice location

12845 Broadway
Alden, NY 14004-1223

Mailing address

12845 Broadway
Alden, NY 14004-1223
Phone (716) 937-3255

Other identifiers 1

IdentifierTypeStateIssuer
01902074MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040804001681 NY Practitioner - Internal Medicine 0648241604 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alden Medical Group PLLCGroup PAC ID 7113998162, 3 clinicians
Buffalo Hearing and Speech Center, IncGroup PAC ID 4183818370, 43 clinicians

Practice addresses (Care Compare)

12845 Broadway St
Alden, NY 14004-1223
Phone (716) 937-3255

50 E N St
Buffalo, NY 14203-1002
Phone (716) 885-8318

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alden Medical Group, PLLC Internal Medicine CurrentSince Jun 17, 2004 Accepting new patients

Locations

12845 Broadway St
Alden, NY 14004
Phone (716) 937-3255

Interoperability endpoints

  • Direct secure messaging: yellamrajukumarmd@aldenmedical.medentdirect.com

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.

Hospital & facility affiliations 8

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332979200000",
    "number": "1326004649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12845 BROADWAY",
            "city": "ALDEN",
            "state": "NY",
            "postal_code": "140041223",
            "telephone_number": "716-937-3255",
            "fax_number": "716-204-7481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12845 BROADWAY",
            "city": "ALDEN",
            "state": "NY",
            "postal_code": "140041223",
            "telephone_number": "716-937-3255",
            "fax_number": "716-204-7481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "YELLAMRAJU",
        "middle_name": "RAVI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2012-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "225749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01902074",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alden, NY

Sources for this page

Verify at the official NPI Registry.