NPIMap

Individual provider Active NPI

Kranthi Kumar Gouravaram, DO

  • Emergency Medicine Physician
  • Bronx, NY
National Provider Identifier
1629538244
Registry record updated Feb 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DO3517 Issued in ME
Practice address
4422 3Rd Ave
Bronx, NY 10457-2545
Phone
(718) 960-9000
NPI assigned
Mar 20, 2019
Last updated
Feb 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X DO3517 ME Primary

Addresses

Primary practice location

4422 3Rd Ave
Bronx, NY 10457-2545

Mailing address

150 4TH Ave Apt PH1
Brooklyn, NY 11217-4557
Phone (925) 984-0235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, OH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230620002959 ME Practitioner - Emergency Medicine 1153789334 Reassigns benefits to 2 organizations
I20250904000476 OH Practitioner - Emergency Medicine 1153789334 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Services of Maine LLCGroup PAC ID 1052657616, 56 clinicians
Emergency Medicine Physicians of Lake County LTDGroup PAC ID 0042444051, 14 clinicians

Practice addresses (Care Compare)

200 Kennedy Memorial Dr
Waterville, ME 04901-4526
Phone (207) 681-3000

36000 Euclid Ave
Willoughby, OH 44094-4625
Phone (440) 375-8166

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Physicians of Lake County LTD Emergency Medicine CurrentSince Jul 1, 2025 Accepting new patients
Columbiana Emergency Physicians LLC Emergency Medicine CurrentSince Sep 1, 2025 Accepting new patients
Calais Community Hospital CurrentSince Jul 1, 2023 Accepting new patients
Emergency Medicine Services of Maine, LLC Emergency Medicine CurrentSince Jul 1, 2023 Accepting new patients
Calais Community Hospital CurrentSince Jul 1, 2023 Accepting new patients

Locations

24 Hospital Ln
Calais, ME 04619
Phone (207) 454-9213

50 Union St
Ellsworth, ME 04605
Phone (207) 664-5304

447 N Main St
Pittsfield, ME 04967
Phone (207) 487-0981

140 Academy St
Presque Isle, ME 04769
Phone (207) 768-4000

200 Kennedy Memorial Dr
Waterville, ME 04901
Phone (207) 861-3000

425 W 5th St
East Liverpool, OH 43920
Phone (330) 385-7200

36000 Euclid Ave
Willoughby Hills, OH 44094
Phone (440) 375-8166

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769990400000",
    "number": "1629538244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 4TH AVE APT PH1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112174557",
            "telephone_number": "925-984-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4422 3RD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104572545",
            "telephone_number": "718-960-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOURAVARAM",
        "first_name": "KRANTHI",
        "middle_name": "KUMAR",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-20",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ME",
            "license": "DO3517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.