Individual provider Active NPI

Samyuktha Ramavaram, M.D

  • Gastroenterology Physician
  • Bettendorf, IA
National Provider Identifier
1467743039
Registry record updated May 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
44464 Issued in IA
Practice address
4321 53Rd Ave
Bettendorf, IA 52722-1269
Phone
(563) 421-5300
NPI assigned
Apr 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Gastroenterology Physician 207RG0100X 44464 IA Primary

Addresses

Primary practice location

4321 53Rd Ave
Bettendorf, IA 52722-1269

Mailing address

4321 53Rd Ave
Bettendorf, IA 52722-1269
Phone (563) 421-5300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address samyuktha.ramavaram@direct.genesishealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, 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
I20170831001154 IA Practitioner - Gastroenterology 8022334564 Reassigns benefits to 2 organizations
I20230118001888 IL Practitioner - Internal Medicine 8022334564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Southwestern Medical School at Dallas, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Health SystemGroup PAC ID 6103829338, 262 clinicians

Practice addresses (Care Compare)

1227 E Rusholme St
Davenport, IA 52803-2459

2222 53Rd Ave
Bettendorf, IA 52722-7546
Phone (563) 421-8900

4700 E 56TH St
Davenport, IA 52807-2904

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.53 of 100Reported as individual
Quality
60.22
Promoting interoperability
97
Improvement activities
40
Cost
67.38

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy585
Upper gastrointestinal (GI) endoscopy for acid reflux378

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44464IAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gengastro LLC CurrentSince Nov 27, 2019 Accepting new patients
Genesis Health System CurrentSince Nov 18, 2019 Accepting new patients
Genesis Health System CurrentSince Nov 18, 2019 Accepting new patients
Genesis Health System Past Accepting new patients

Locations

2222 53rd Ave
Bettendorf, IA 52722
Phone (319) 383-2686

865 Lincoln Rd
Ste 100
Bettendorf, IA 52722
Phone (563) 355-1000

4700 E 56th St
Ste 100
Davenport, IA 52807
Phone (563) 383-2667

1227 E Rusholme St
Davenport, IA 52803
Phone (563) 324-8160

1351 W Central Park Ave
Ste 340
Davenport, IA 52804
Phone (563) 421-1287

801 Illini Dr
Silvis, IL 61282
Phone (309) 281-4000

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1304035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619913600000",
    "number": "1467743039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4321 53RD AVE",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221269",
            "telephone_number": "563-421-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4321 53RD AVE",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221269",
            "telephone_number": "563-421-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMAVARAM",
        "first_name": "SAMYUKTHA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-29",
        "last_updated": "2021-05-02",
        "certification_date": "2021-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IA",
            "license": "44464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "samyuktha.ramavaram@direct.genesishealth.com",
            "affiliation": "N",
            "endpointDescription": "Genesis Health System Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "4321 53rd Ave",
            "city": "Bettendorf",
            "state": "IA",
            "country_code": "US",
            "postal_code": "527221269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bettendorf, IA

Sources for this page

Verify at the official NPI Registry.