Individual provider Active NPI

Lakshmi S Ramanujam, M.D.

  • Specialist
  • Sacramento, CA
National Provider Identifier
1629073622
Registry record updated Mar 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A042533 Issued in CA
Practice address
3701 J St
Ste 210
Sacramento, CA 95816-5542
Phone
(916) 736-2710
Fax
(916) 736-3240
NPI assigned
Jun 16, 2005
Reactivated
Mar 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A042533 CA Primary

Addresses

Primary practice location

3701 J St
Ste 210
Sacramento, CA 95816-5542

Mailing address

3701 J Street
Suite 210
Sacramento, CA 95826
Phone (916) 736-2710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20100326000141 CA Practitioner - Internal Medicine 7214063577 Practice locations: Sacramento, CA; Placerville, CA; Fair Oaks, CA; Citrus Heights, CA; Carmichael, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A042533CAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426118400000",
    "number": "1629073622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 J STREET",
            "address_2": "SUITE 210",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95826",
            "telephone_number": "916-736-2710",
            "fax_number": "916-736-3240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 J ST",
            "address_2": "STE 210",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165542",
            "telephone_number": "916-736-2710",
            "fax_number": "916-736-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMANUJAM",
        "first_name": "LAKSHMI",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2015-03-12",
        "deactivation_date": "2006-03-17",
        "reactivation_date": "2006-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A042533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.