Individual provider Active NPI

Charalambos Kyriakos Rammos, MD

  • Surgery Physician
  • Peoria, IL
National Provider Identifier
1821298555
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
36.129302 Issued in IL
Practice address
4911 N Executive Dr Ste 100
Peoria, IL 61614-4896
Phone
(309) 670-0951
Fax
(309) 670-0733
NPI assigned
Jul 20, 2007
Last updated
Dec 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 125053834 IL
Surgery Physician 208600000X 36.129302 IL Primary
Plastic and Reconstructive Surgery Physician 2086S0122X 106177 MN
Plastic and Reconstructive Surgery Physician 2086S0122X 55759 MN

Addresses

Primary practice location

4911 N Executive Dr Ste 100
Peoria, IL 61614-4896

Mailing address

4911 N Executive Dr Ste 100
Peoria, IL 61614-4896
Phone (309) 670-0951

Other practice location 1

200 1st St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20160616002083 IL Practitioner - Plastic and Reconstructive Surgery 1658528948 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125053834ILMDSurgery Physician
36.129302ILMDSurgery Physician
55759MNMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Mar 25, 2024 Accepting new patients

Locations

1001 Main St
Ste 300
Peoria, IL 61606
Phone (309) 495-0200

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

Interoperability endpoints

  • Direct secure messaging: charalambos.rammos.1@28977.direct.athenahealth.com
  • Direct secure messaging: rammos@peoria.directbygreenway.com

Organizations & group practices 2

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": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1821298555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4911 N EXECUTIVE DR STE 100",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144896",
            "telephone_number": "309-670-0951",
            "fax_number": "309-670-0733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4911 N EXECUTIVE DR STE 100",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144896",
            "telephone_number": "309-670-0951",
            "fax_number": "309-670-0733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050001",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAMMOS",
        "first_name": "CHARALAMBOS",
        "middle_name": "KYRIAKOS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-20",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "125053834",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "36.129302",
            "primary": true
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MN",
            "license": "106177",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MN",
            "license": "55759",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.