NPIMap

Individual provider Active NPI

Kondaramvalappil K Ravindran, MD

  • Cardiovascular Disease Physician
  • Saginaw, MI
National Provider Identifier
1790771319
Registry record updated Oct 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
43010037197 Issued in MI
Practice address
900 Cooper Ave
Suite 4100
Saginaw, MI 48602-5182
Phone
(989) 497-9395
Fax
(989) 497-9599
NPI assigned
Sep 20, 2005
Last updated
Oct 19, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 43010037197 MI Primary
Interventional Cardiology Physician 207RI0011X 4301037197 MI
Nuclear Cardiology Physician 207UN0901X 4301037197 MI

Addresses

Primary practice location

900 Cooper Ave
Suite 4100
Saginaw, MI 48602-5182

Mailing address

900 Cooper Ave
Suite 4100
Saginaw, MI 48602-5182
Phone (989) 497-9395

Other identifiers 1

IdentifierTypeStateIssuer
KR037197OtherMILICENSE #

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

State licenses

LicenseStateTypeSpecialty
43010037197MIMDCardiovascular Disease Physician
4301037197MIMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Advanced Neurology Center, PLLC PastSince Jan 1, 2005 Accepting new patients
Michigan Cardiovascular Institute, PC Cardiovascular Disease Past Accepting new patients
Valley Cardiology P C Cardiovascular Disease PastSince Jul 1, 1998 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350604800000",
    "number": "1790771319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 COOPER AVE",
            "address_2": "SUITE 4100",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486025182",
            "telephone_number": "989-497-9395",
            "fax_number": "989-497-9599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 COOPER AVE",
            "address_2": "SUITE 4100",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486025182",
            "telephone_number": "989-497-9395",
            "fax_number": "989-497-9599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVINDRAN",
        "first_name": "KONDARAMVALAPPIL",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2012-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "43010037197",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MI",
            "license": "4301037197",
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "MI",
            "license": "4301037197",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "KR037197",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; 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.