Individual provider Active NPI

Avinash Ravilla, D.O

  • General Practice Physician
  • New York, NY
National Provider Identifier
1376926063
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
304276 Issued in NY
Practice address
150 W 22ND St FL 8
New York, NY 10011-6557
Phone
(470) 594-4450
NPI assigned
Jun 30, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MB10481300 NJ
General Practice Physician 208D00000X 304276 NY Primary

Addresses

Primary practice location

150 W 22ND St FL 8
New York, NY 10011-6557

Mailing address

PO Box 23607
New York, NY 10087-3607
Phone (646) 809-4094

Other practice location 1

2119 E Norris St
Philadelphia, PA 19125-1924
Phone (973) 400-9564

Other practice location 2

703 Main St
Paterson, NJ 07503-2621
Phone (973) 754-2240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY, PA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20190807002128 NJ Practitioner - Emergency Medicine 2062749427 Reassigns benefits to 1 organization
I20210804003959 NY Practitioner - General Practice 2062749427 Reassigns benefits to 3 organizations
I20241227000450 PA Practitioner - General Practice 2062749427

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York Remote Medical PCGroup PAC ID 5395121628, 4 clinicians
Perry Medical Group of Florida PAGroup PAC ID 8729481197, 15 clinicians

Practice addresses (Care Compare)

215 Park Ave S
FL 11
New York, NY 10003-1626
Phone (978) 850-3914

58 Juniper Ter
Tuxedo Park, NY 10987-4769
Phone (978) 850-3914

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB10481300NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ravillamed PLLC Emergency Medicine CurrentSince Oct 26, 2024 Accepting new patients
St. Joseph'S Emergency Physicians Inc CurrentSince Jul 1, 2019 Accepting new patients
Perry Medical Group of New Jersey PA General Practice CurrentSince Jun 17, 2021 Accepting new patients
New York Remote Medical PC General Practice CurrentSince Aug 30, 2022 Accepting new patients
Perry Medical Group of Florida PA General Practice CurrentSince Jul 13, 2021 Accepting new patients
Cloud Health Medical Group, P.a. Past Accepting new patients

Locations

1 Sansome St
Ste 3500
San Francisco, CA 94104
Phone (604) 423-4050

3355 Lenox Rd NE
Ste 750
Atlanta, GA 30326
Phone (470) 682-3536

703 Main St
Bldg 400
Paterson, NJ 07503
Phone (973) 754-2054

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

150 W 22nd St
Fl 8
New York, NY 10011
Phone (646) 809-4094

215 Park Ave S
Fl 11
New York, NY 10003
Phone (212) 725-7774

701 Tillery St
Ste 12
Austin, TX 78702
Phone (512) 270-9622

750 N Saint Paul St
Ste 250
Dallas, TX 75201
Phone (773) 389-1899

440 Monticello Ave
Ste 1802
Norfolk, VA 23510
Phone (757) 447-4335

4108 E Parham Rd
Ste 100
Richmond, VA 23228
Phone (804) 206-3034

Organizations & group practices 6

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": "1435622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1376926063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23607",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100873607",
            "telephone_number": "646-809-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W 22ND ST FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100116557",
            "telephone_number": "470-594-4450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2119 E Norris St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191251924",
            "country_code": "US",
            "telephone_number": "973-400-9564",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "703 Main St",
            "address_purpose": "LOCATION",
            "city": "Paterson",
            "state": "NJ",
            "postal_code": "075032621",
            "country_code": "US",
            "telephone_number": "973-754-2240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAVILLA",
        "first_name": "AVINASH",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-30",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MB10481300",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "304276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.