Individual provider Active NPI

Raja Ravella, MD

  • Anesthesiology Physician
  • Valparaiso, IN
National Provider Identifier
1770596108
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01038268 Issued in IN
Practice address
814 Laporte Ave
Valparaiso, IN 46383-5860
Phone
(219) 531-7151
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 01038268 IN Primary

Addresses

Primary practice location

814 Laporte Ave
Valparaiso, IN 46383-5860

Mailing address

541 Otis Bowen Dr
Munster, IN 46321-4158
Phone (219) 934-5300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080430000454 IN Practitioner - Anesthesiology 4284523929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Porter County Anesthesia Associates PCGroup PAC ID 4789573411, 29 clinicians

Practice addresses (Care Compare)

85 E US Hwy 6
Valparaiso, IN 46383-8947
Phone (219) 983-5743

Hospital & facility affiliations

  • Northwest Health - Porter Hospital, Valparaiso, IN, CCN 150035

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01038268INMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Porter County Anesthesia Associates PC Anesthesiology CurrentSince Oct 1, 2003 Accepting new patients

Locations

9301 Connecticut Dr
Crown Point, IN 46307
Phone (219) 756-2100

85 E US Highway 6
Valparaiso, IN 46383
Phone (219) 983-5743

814 Laporte Ave
Valparaiso, IN 46383
Phone (219) 263-4600

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770596108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 OTIS BOWEN DR",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463214158",
            "telephone_number": "219-934-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 LAPORTE AVE",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463835860",
            "telephone_number": "219-531-7151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVELLA",
        "first_name": "RAJA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01038268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

Verify at the official NPI Registry.