Organization Active NPI

Suman Chandra Ravuri, MD

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1750445771
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
239313 Issued in NY
Legal business name
SUMAN CHANDRA RAVURI, MD
Practice address
585 Schenectady Ave
Suite D
Brooklyn, NY 11203-1822
Phone
(718) 604-5402
NPI assigned
Dec 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Imran Hameed, PHD
Title
Manager
Phone
(718) 604-5469

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 239313 NY Primary

Addresses

Primary practice location

585 Schenectady Ave
Suite D
Brooklyn, NY 11203-1822

Mailing address

912 N 1St St
New Hyde Park, NY 11040-2822
Phone (718) 288-8203

Other identifiers 2

IdentifierTypeStateIssuer
239313OtherNYNEW YORK LICENSE
043990OtherCTCONNECTICUT LICENSE

National Provider Directory

National Provider Directory

Locations

585 Schenectady Ave
Ste D
Brooklyn, NY 11203

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750445771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 N 1ST ST",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110402822",
            "telephone_number": "718-288-8203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 SCHENECTADY AVE",
            "address_2": "SUITE D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031822",
            "telephone_number": "718-604-5402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMAN CHANDRA RAVURI, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAMEED",
        "authorized_official_first_name": "IMRAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "718-604-5469",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "239313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK LICENSE",
            "identifier": "239313",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICUT LICENSE",
            "identifier": "043990",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.