Individual provider Active NPI

Gopalswamy Kalyanaraman, DDS

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1447231683
Registry record updated Feb 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
034553 Issued in NY
Practice address
361 Eastern Pkwy
Brooklyn, NY 11216-4103
Phone
(718) 789-6300
Fax
(718) 789-6785
NPI assigned
Nov 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 034553 NY Primary

Addresses

Primary practice location

361 Eastern Pkwy
Brooklyn, NY 11216-4103

Mailing address

49 Nottingham Rd
New Hyde Park, NY 11040-2212
Phone (516) 326-2841

Other identifiers 1

IdentifierTypeStateIssuer
00408342MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150519000347 NY Order and Referring Only - DentistPractitioner - Dentist 7719207596

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
034553NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
G.K. Raman DDS,Fagd Past Accepting new patients

Organizations & group practices 1

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": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424044800000",
    "number": "1447231683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 NOTTINGHAM RD",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110402212",
            "telephone_number": "516-326-2841",
            "fax_number": "718-789-6785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 EASTERN PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112164103",
            "telephone_number": "718-789-6300",
            "fax_number": "718-789-6785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALYANARAMAN",
        "first_name": "GOPALSWAMY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2015-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "034553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00408342",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.