Individual provider Active NPI

Chaitanya Kumar Ravi, M.D.

  • Internal Medicine Physician
  • Randallstown, MD
National Provider Identifier
1376504027
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D37333 Issued in MD
Practice address
5401 Old Court Rd
Randallstown, MD 21133-5103
Phone
(410) 521-2200
NPI assigned
Mar 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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 D37333 MD Primary

Addresses

Primary practice location

5401 Old Court Rd
Randallstown, MD 21133-5103

Mailing address

5401 Old Court Rd
Attn: Credentialing
Randallstown, MD 21133-5103
Phone (410) 601-5524

Other identifiers 5

IdentifierTypeStateIssuer
P00309485OtherMDR/R MEDICARE PROVIDER #
CA8374OtherMDR/R MEDICARE GROUP #
110167459OtherMDR/R MEDICARE PROVIDER #
594321300MedicaidMD
CN6601OtherMDR/R MEDICARE GROUP #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20041207000141 MD Practitioner - Internal Medicine 0749183895 Reassigns benefits to 3 organizations
Practice locations: Baltimore, MD; Randallstown, MD

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northwest Hospital Center IncGroup PAC ID 6204739352, 90 clinicians
Lifebridge Community Physicians IncGroup PAC ID 3678751468, 183 clinicians

Practice addresses (Care Compare)

5401 Old Court Rd
Randallstown, MD 21133-5103
Phone (410) 701-4434

8600 Liberty Rd
Randallstown, MD 21133-4707
Phone (410) 521-4211

Hospital & facility affiliations

  • Homecare Maryland, LLC Home health agency, Owings Mills, MD, CCN 217107
  • Northwest Hospital Center Hospital, Randallstown, MD, CCN 210040
  • Sinai Hospital of Baltimore Hospital, Baltimore, MD, CCN 210012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D37333MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifebridge Community Physicians Inc CurrentSince Jun 30, 2016 Accepting new patients
Sinai Hospital of Baltimore Inc Internal Medicine CurrentSince Jul 25, 2005 Accepting new patients
Sinai Hospital of Baltimore Inc Current Accepting new patients
Northwest Hospital Center, Inc Internal Medicine CurrentSince Oct 1, 1996 Accepting new patients
Northwest Hospital Center, Inc. CurrentSince Oct 1, 1996 Accepting new patients
Sinai Hospital of Baltimore, Inc. CurrentSince Jul 25, 2005 Accepting new patients
Lifebridge Community Physicians, Inc. Internal Medicine CurrentSince Jun 30, 2016 Accepting new patients
Lifebridge Community Physicians, Inc Current Accepting new patients
Northwest Hospital Center, Inc Past Accepting new patients
Sinai Hospital of Baltimore Inc Past Accepting new patients
Northwest Hospital Center, Inc Past Accepting new patients
Northwest Hospital Center, Inc. Past Accepting new patients
Northwest Hospital Center, Inc Past Accepting new patients
Sinai Hospital of Baltimore Inc Past Accepting new patients
Sinai Hospital of Baltimore Inc Past Accepting new patients
Northwest Hospital Center, Inc Past Accepting new patients
Sinai Hospital of Baltimore Inc Internal Medicine Past Accepting new patients
Sinai Hospital of Baltimore Inc Past Accepting new patients
Sinai Hospital of Baltimore, Inc. Past Accepting new patients
Sinai Hospital of Baltimore Inc Past Accepting new patients
Sinai Hospital of Baltimore Inc Past Accepting new patients
Sinai Hospital of Baltimore Inc Past Accepting new patients
Sinai Hospital of Baltimore Inc Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2435 W Belvedere Ave
Ste 56
Baltimore, MD 21215
Phone (410) 578-8632

2435 W Belvedere Ave
Ste 22
Baltimore, MD 21215
Phone (410) 601-6340

2401 W Belvedere Ave
Baltimore, MD 21215

8600 Liberty Rd
Randallstown, MD 21133
Phone (410) 366-5600

8600 Liberty Rd
Fl 2
Randallstown, MD 21133
Phone (410) 521-4211

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

410 Malcolm Dr
Ste A
Westminster, MD 21157
Phone (410) 876-1633

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/136fea15-c667-40bc-9ed2-b1115d62123b/

Organizations & group practices 24

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.

View all 24

Hospital & facility affiliations 4

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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1376504027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 OLD COURT RD",
            "address_2": "ATTN: CREDENTIALING",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211335103",
            "telephone_number": "410-601-5524",
            "fax_number": "410-601-8946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 OLD COURT RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211335103",
            "telephone_number": "410-521-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVI",
        "first_name": "CHAITANYA",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D37333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R/R MEDICARE PROVIDER #",
            "identifier": "P00309485",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R/R MEDICARE GROUP #",
            "identifier": "CA8374",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R/R MEDICARE PROVIDER #",
            "identifier": "110167459",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "594321300",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R/R MEDICARE GROUP #",
            "identifier": "CN6601",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Randallstown, MD

Sources for this page

Verify at the official NPI Registry.