Organization Active NPI

Ratakonda,M.D., P.a.

  • Diagnostic Radiology Physician
  • Morristown, NJ
National Provider Identifier
1790784353
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
RATAKONDA,M.D., P.A.
Practice address
290 Madison Ave
Morristown, NJ 07960-7400
Phone
(973) 538-8317
Fax
(973) 538-6565
NPI assigned
Jul 17, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Authorized official

Name
Sridevi Ratakonda, MDNPI 1912907411
Title
President
Phone
(973) 538-8317

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X NJ Primary

Addresses

Primary practice location

290 Madison Ave
Morristown, NJ 07960-7400

Mailing address

290 Madison Ave
Morristown, NJ 07960-7400
Phone (973) 538-8317

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040331000409 NJ Part B Supplier - Clinic/Group Practice 1254323314 Receives reassigned benefits from 3 practitioners
Practice locations: Morristown, NJ

National Provider Directory

National Provider Directory

Locations

290 Madison Ave
Ste 4
Morristown, NJ 07960
Phone (973) 538-8181

290 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5338

Practitioners & affiliated clinicians

Practitioners 7

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": "1121558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1790784353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 MADISON AVE",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079607400",
            "telephone_number": "973-538-8317",
            "fax_number": "973-538-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 MADISON AVE",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079607400",
            "telephone_number": "973-538-8317",
            "fax_number": "973-538-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RATAKONDA,M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-17",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "RATAKONDA",
        "authorized_official_first_name": "SRIDEVI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-538-8317",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.