Jaikumar Ravunniarath Medical P.C.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

251537 Issued in NY

Legal business name

JAIKUMAR RAVUNNIARATH MEDICAL P.C.

Practice address

New Paltz Center for Rehab and Nursing
1 Jansen Road
New Paltz, NY 12561-3811

Phone

(845) 255-0830

NPI assigned

Nov 11, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Jaikumar Ravunniarath Menon, MDNPI 1427000934

Title

Owner

Phone

(845) 594-8895

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jaikumar Ravunniarath Menon, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Poughkeepsie, NY
  • NPI 1427000934
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1510358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730764800000",
    "number": "1629581749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 WILDWOOD DR",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126035828",
            "telephone_number": "845-594-8895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NEW PALTZ CENTER FOR REHAB AND NURSING",
            "address_2": "1 JANSEN ROAD",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125613811",
            "telephone_number": "845-255-0830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "LUTHERAN CARE CENTER",
            "address_2": "965 DUTCHESS TURNPIKE",
            "address_purpose": "LOCATION",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "12603",
            "country_code": "US",
            "telephone_number": "845-486-9494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JAIKUMAR RAVUNNIARATH MEDICAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-11",
        "last_updated": "2024-11-05",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "MENON",
        "authorized_official_first_name": "JAIKUMAR",
        "authorized_official_middle_name": "RAVUNNIARATH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-594-8895",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "251537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Jane Irvine, M.S.
• It'S a Girl Thing Counseling Amy Frisch LCSW, PLLC
• Robert Jacobsen, DPT
• Amy C. Jacobson, LCSW-R
• Gary Michael Jacobson, LCSW, CASAC
• Anna Aurora Jakubek, FNP-BC
• Shannon H James, RPH
• Richard M Janof, DC
• Jansen Road Nursing and Rehabilitation Center LLC
• Denise Katherine Jelley, LCSW R

• Skilled Nursing Facility in New Paltz, NY
• Providers in New Paltz, NY by specialty
• Skilled Nursing Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.