Individual provider Active NPI

Sriram Ramgopal, MBBS

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Chicago, IL
National Provider Identifier
1427391515
Registry record updated Sep 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
036.150393 Issued in IL
Practice address
255 E Chicago Ave
Chicago, IL 60611-2605
Phone
(312) 227-6101
NPI assigned
Mar 27, 2013
Last updated
Sep 30, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 036.150393 IL Primary

Addresses

Primary practice location

255 E Chicago Ave
Chicago, IL 60611-2605

Mailing address

255 E Chicago Ave
Chicago, IL 60611-2605

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, IL2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20180515001380 PA Practitioner - Pediatric Medicine 3375807670 Reassigns benefits to 1 organization
I20210407001953 IL Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 3375807670 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.150393ILMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians Pediatric Emergency Medicine CurrentSince Jul 1, 2018 Accepting new patients
University of Pittsburgh Physicians CurrentSince Jul 1, 2018 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2021 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2021 Accepting new patients
Lurie Children's Medical Group Inc CurrentSince Jan 1, 2021 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Claims Remittance
Carol Stream, IL 60122

Dept 5777
Carol Stream, IL 60122

225 E Chicago Ave
Chicago, IL 60611
Phone (312) 227-4090

737 N Michigan Ave
Ste 2040
Chicago, IL 60611

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864

4401 Penn Ave
Pittsburgh, PA 15224
Phone (412) 692-5030

4401 Penn Ave
Ste 2400
Pittsburgh, PA 15224
Phone (412) 692-7980

519 Penn Ave
Ste 206
Turtle Creek, PA 15145
Phone (412) 823-3121

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1427391515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 E CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 E CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112605",
            "telephone_number": "312-227-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMGOPAL",
        "first_name": "SRIRAM",
        "name_prefix": "Dr.",
        "credential": "MBBS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-27",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "IL",
            "license": "036.150393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.