Individual provider Active NPI

Nellepelly K Raman, M.D.

  • Internal Medicine Physician
  • Valley Stream, NY
National Provider Identifier
1710071337
Registry record updated Jan 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
171751 Issued in NY
Practice address
30 East Sunrise Highway
Suite 108
Valley Stream, NY 11581
Phone
(516) 791-5804
Fax
(516) 791-5809
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 171751 NY Primary

Addresses

Primary practice location

30 East Sunrise Highway
Suite 108
Valley Stream, NY 11581

Mailing address

30 East Sunrise Highway
Suite 108
Valley Stream, NY 11581
Phone (516) 791-5804

Other identifiers 1

IdentifierTypeStateIssuer
01040495MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389744000000",
    "number": "1710071337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 EAST SUNRISE HIGHWAY",
            "address_2": "SUITE 108",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "11581",
            "telephone_number": "516-791-5804",
            "fax_number": "516-791-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 EAST SUNRISE HIGHWAY",
            "address_2": "SUITE 108",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "11581",
            "telephone_number": "516-791-5804",
            "fax_number": "516-791-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMAN",
        "first_name": "NELLEPELLY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2014-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "171751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01040495",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.