NPIMap

Individual provider Active NPI

Ravi S Menon, M.D.

  • Internal Medicine Physician
  • Milford, MA
National Provider Identifier
1649557851
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
292434 Issued in MA
Practice address
101 Cedar St
Milford, MA 01757-1101
Phone
(508) 634-5026
Fax
(508) 634-5055
NPI assigned
Nov 16, 2011
Last updated
Aug 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X PERMIT TX
Internal Medicine Physician 207R00000X 292434 MA Primary
Internal Medicine Physician 207R00000X 0101252069 VA

Addresses

Primary practice location

101 Cedar St
Milford, MA 01757-1101

Mailing address

101 Cedar St
Milford, MA 01757-1101
Phone (508) 634-5026

Other names 1

  • Mr. Ravisankar Elayidathingal Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220901001364 MA Practitioner - Internal Medicine 2860626850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

101 Cedar St
Milford, MA 01757-1101
Phone (508) 634-3100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PERMITTXMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Medical Group, Inc Internal Medicine CurrentSince Sep 26, 2022 Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

101 Cedar St
Milford, MA 01757
Phone (508) 634-5000

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

5 Neponset St
Fl 12
Worcester, MA 01606
Phone (508) 852-6175

Interoperability endpoints

  • Direct secure messaging: ravi.menon.npi1649557851.reliant@direct.optumcare.masshiway.net

Organizations & group practices 2

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 4

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": "1321401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1649557851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CEDAR ST",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017571101",
            "telephone_number": "508-634-5026",
            "fax_number": "508-634-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CEDAR ST",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017571101",
            "telephone_number": "508-634-5026",
            "fax_number": "508-634-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENON",
        "first_name": "RAVI",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-16",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "PERMIT",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "292434",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101252069",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAVISANKAR",
            "last_name": "ELAYIDATHINGAL",
            "prefix": "MR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Milford, MA

Sources for this page

Verify at the official NPI Registry.