NPIMap

Individual provider Active NPI

Chickamagalur N Raveesh, MD

  • Internal Medicine Physician
  • Escanaba, MI
National Provider Identifier
1427043843
Registry record updated Jul 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301068941 Issued in MI
Practice address
3409 Ludington St Ste 203
Escanaba, MI 49829-4213
Phone
(906) 786-5707
Fax
(906) 789-4446
NPI assigned
Sep 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2009

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 4301068941 MI Primary

Addresses

Primary practice location

3409 Ludington St Ste 203
Escanaba, MI 49829-4213

Mailing address

3409 Ludington St Ste 203
Escanaba, MI 49829-4213
Phone (906) 786-5707

Other identifiers 3

IdentifierTypeStateIssuer
3286162MedicaidMI
381358036014OtherMITRICARE
110127992OtherMIRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040722000676 MI Practitioner - Internal Medicine 5092795807 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cedar Hill Medical PCGroup PAC ID 5395840672, 6 clinicians

Practice addresses (Care Compare)

2845 US Hwy 2 41
Suite 201
Bark River, MI 49807-9661
Phone (906) 466-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.52 of 100Reported as group
Quality
100
Improvement activities
40
Cost
71.75

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cedar Hill Medical PC CurrentSince Feb 3, 2020 Accepting new patients
Marquette General Hospital, Inc. Past Accepting new patients

Locations

2845 US Highway 2 41
Ste 201
Bark River, MI 49807
Phone (906) 466-2000

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 and National Provider Directory roles.

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": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247529600000",
    "number": "1427043843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3409 LUDINGTON ST STE 203",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498294213",
            "telephone_number": "906-786-5707",
            "fax_number": "906-789-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3409 LUDINGTON ST STE 203",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498294213",
            "telephone_number": "906-786-5707",
            "fax_number": "906-789-4446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVEESH",
        "first_name": "CHICKAMAGALUR",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2009-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301068941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3286162",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "381358036014",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110127992",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Escanaba, MI

Sources for this page

Verify at the official NPI Registry.