Individual provider Active NPI

Bhanu Ravindran, MD

  • Internal Medicine Physician
  • Rock Island, IL
National Provider Identifier
1336484013
Registry record updated Dec 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036.131659 Issued in IL
Practice address
2701, 17TH St
Trinity Medical Centre
Rock Island, IL 61201
Phone
(309) 779-5000
NPI assigned
Dec 6, 2012
Last updated
Dec 6, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 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 036.131659 IL Primary

Addresses

Primary practice location

2701, 17TH St
Trinity Medical Centre
Rock Island, IL 61201

Mailing address

3723 53Rd Ave
Springs at Bettendorf
Bettendorf, IA 52722-1191
Phone (563) 823-8404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20130530000593 IL Practitioner - Internal Medicine 1153569207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

600 John Deere Rd
Moline, IL 61265-6812

600 N College Ave
Suite 110
Geneseo, IL 61254-1092
Phone (563) 264-9300

600 N College Ave
Suite 120
Geneseo, IL 61254-1095
Phone (309) 944-5342

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.131659ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Iowa Physicians Clinic Medical Foundation Internal Medicine CurrentSince Jan 2, 2014 Accepting new patients

Locations

8101 Birchwood Ct
Unit R
Urbandale, IA 50131
Phone (515) 471-9363

600 N College Ave
Ste 120
Geneseo, IL 61254
Phone (309) 944-5342

5401 44th Avenue Dr
Ste 100
Moline, IL 61265
Phone (309) 779-5439

600 John Deere Rd
Ste 401
Moline, IL 61265
Phone (309) 779-3627

2701 17th St
Rock Island, IL 61201
Phone (309) 779-3200

Interoperability endpoints

  • Direct secure messaging: bravindran132551@direct.unitypoint.org

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 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": "1354752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354752000000",
    "number": "1336484013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3723 53RD AVE",
            "address_2": "SPRINGS AT BETTENDORF",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221191",
            "telephone_number": "563-823-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701, 17TH ST",
            "address_2": "TRINITY MEDICAL CENTRE",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "61201",
            "telephone_number": "309-779-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVINDRAN",
        "first_name": "BHANU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-06",
        "last_updated": "2012-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.131659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Island, IL

Sources for this page

Verify at the official NPI Registry.