Ethan Ravetch, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

290370 Issued in NY

Practice address

1250 Waters Place
Tower 1, 7TH Floor
Bronx, NY 10461

Phone

(929) 246-6300

NPI assigned

Apr 6, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Group practices

Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989

Interoperability endpoints

• Direct secure messaging: eravetch@montefioredirect.com
• Direct secure messaging: eravetch844018@nychhc.direct-ci.com

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.

• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152

  Surgery

  Medicare reassignment Care Compare group NPD
• Montefiore Medical Center

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1194183715
  NPD
• Montefiore Medical Center

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1952476988
  NPD (past)
• Montefiore Mount Vernon Hospital

  • General Acute Care Hospital
  • Mount Vernon, NY
  • NPI 1013345065
  NPD (past)

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

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1447645445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1468 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296508",
            "telephone_number": "212-241-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 WATERS PLACE",
            "address_2": "TOWER 1, 7TH FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10461",
            "telephone_number": "929-246-6300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 E 210th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672401",
            "country_code": "US",
            "telephone_number": "718-696-2583",
            "fax_number": "718-881-5074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAVETCH",
        "first_name": "ETHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-06",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "290370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yaren Joeliz Ravel, LMHC
• Selma Anne Raven, MS. ED.
• Gladys Yaneth Raveneau, M.D.
• Tashi Raveneau, MSED
• Ericka Ravenell, PHYSICIAN ASSISTANT
• Ravi Physician PC
• Ram Prasad Ravi, M.D.
• Srinivas M Ravi, M.D.
• Venkata Ramana Ravi, M.D.
• Veerabadran Ravichandran, MD

• Surgery Physician in Bronx, NY
• Providers in Bronx, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.