Individual provider Active NPI

Raveena Gill, MBBS

  • Addiction Psychiatry Physician
  • Syracuse, NY
National Provider Identifier
1477172070
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Psychiatry PhysicianTaxonomy code 2084P0802X
License
325893 Issued in NY
Practice address
301 Prospect Ave
Syracuse, NY 13203-1807
Phone
(708) 973-1922
NPI assigned
Apr 13, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 325893 NY
Addiction Psychiatry Physician 2084P0802X 325893 NY Primary

Addresses

Primary practice location

301 Prospect Ave
Syracuse, NY 13203-1807

Mailing address

301 Prospect Ave
Syracuse, NY 13203-1807
Phone (708) 973-1922

Other practice location 1

719 Harrison St
Syracuse, NY 13210-2695
Phone (315) 464-3265

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY2 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
I20240730000805 CT Practitioner - Psychiatry 5294192282 Reassigns benefits to 1 organization
I20250609000300 NY Practitioner - Psychiatry 5294192282 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psychiatry Faculty Practice, IncGroup PAC ID 9234458530, 90 clinicians

Practice addresses (Care Compare)

4900 Broad Rd
Syracuse, NY 13215-2265
Phone (315) 464-3265

713 Harrison St
BLDG 3
Syracuse, NY 13210-2305
Phone (315) 464-3265

719 Harrison St
Syracuse, NY 13210-2305

750 E Adams St
Cab Room 320
Syracuse, NY 13210-1834

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince May 23, 2024 Accepting new patients
State of Connecticut CurrentSince May 23, 2024 Accepting new patients
St. Joseph's Pathology, PC Current Accepting new patients
Psychiatry Faculty Practice, Inc. Psychiatry CurrentSince Jul 1, 2025 Accepting new patients
St Josephs Hospital Health Center CurrentSince Jun 15, 2025 Accepting new patients
St Joseph's Hospital Health Center Psychiatry CurrentSince Jun 15, 2025 Accepting new patients

Locations

165 Capitol Ave
Ste 2000
Hartford, CT 06106

34 Park St
North Haven, CT 06519
Phone (203) 974-7417

301 Prospect Ave
Ste 706
Syracuse, NY 13203
Phone (315) 703-5200

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

713 Harrison St
Bldg 3
Syracuse, NY 13210
Phone (315) 464-3265

719 Harrison St
Syracuse, NY 13210
Phone (315) 464-3265

Interoperability endpoints

  • Direct secure messaging: rgill106471@direct.upstate.edu
  • Direct secure messaging: rgill4460601@direct.trinity-health.org

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1477172070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031807",
            "telephone_number": "708-973-1922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031807",
            "telephone_number": "708-973-1922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "719 Harrison St",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132102695",
            "country_code": "US",
            "telephone_number": "315-464-3265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILL",
        "first_name": "RAVEENA",
        "credential": "MBBS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-13",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "325893",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "NY",
            "license": "325893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.