Individual provider Active NPI

Kristina V Raveendran, M.D.

  • Family Medicine Physician
  • New Orleans, LA
National Provider Identifier
1518254010
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD.206906 Issued in LA
Practice address
2820 Napoleon Ave
Suite 890
New Orleans, LA 70115-6969
Phone
(504) 842-4960
Fax
(504) 842-4251
NPI assigned
Jul 5, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125060532 IL
Family Medicine Physician 207Q00000X MD.206906 LA Primary

Addresses

Primary practice location

2820 Napoleon Ave
Suite 890
New Orleans, LA 70115-6969

Mailing address

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (524) 842-4000

Other identifiers 2

IdentifierTypeStateIssuer
01001734MedicaidMS
2368702MedicaidLA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, CA2 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
I20140911000572 LA Practitioner - Family Practice 3971722679 Reassigns benefits to 2 organizations
I20201109000528 CA Practitioner - Family PracticePractitioner - Other (Physician) 3971722679 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125060532ILMDFamily Medicine Physician
MD.206906LAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC Current Accepting new patients
Ochsner Clinic LLC CurrentSince Jul 1, 2014 Accepting new patients
Permanente Medical Group Inc Family Medicine CurrentSince Aug 5, 2020 Accepting new patients
Lsu Health Sciences Center Shreveport Faculty Group Practice Family Medicine CurrentSince Nov 15, 2023 Accepting new patients
Ochsner Clinic LLC CurrentSince Jul 1, 2014 Accepting new patients
Permanente Medical Group Inc Family Medicine Current Accepting new patients
Permanente Medical Group, Inc CurrentSince Aug 5, 2020 Accepting new patients

Locations (25 of 38)

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

1800 Harrison St
Fl 7
Oakland, CA 94612

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

2113 Airline Dr
Ste 100
Bossier City, LA 71111
Phone (318) 519-3088

1111 Greengate Dr
Ste B
Covington, LA 70433
Phone (985) 246-2420

27342 Juban Rd
Ste 102
Denham Springs, LA 70726
Phone (225) 388-6130

5922 W Main St
Ste A
Houma, LA 70360
Phone (985) 262-8015

3417 Williams Blvd
Kenner, LA 70065
Phone (504) 461-9660

12895 Highway 90
Ste H
Luling, LA 70070
Phone (985) 331-9400

1849 Barataria Blvd
Ste B
Marrero, LA 70072
Phone (504) 309-5015

2215 Veterans Memorial Blvd
Metairie, LA 70002
Phone (504) 838-3524

4864 Jackson St
Monroe, LA 71202
Phone (318) 330-7000

2820 Napoleon Ave
Ste 890
New Orleans, LA 70115
Phone (504) 412-1366

Organizations & group practices 7

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": "1309824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1518254010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701212429",
            "telephone_number": "524-842-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 NAPOLEON AVE",
            "address_2": "SUITE 890",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701156969",
            "telephone_number": "504-842-4960",
            "fax_number": "504-842-4251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVEENDRAN",
        "first_name": "KRISTINA",
        "middle_name": "V",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-05",
        "last_updated": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125060532",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "MD.206906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01001734",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2368702",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "501 J St",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "958142325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.