Individual provider Active NPI

Neelakantan Ramineni, MD

  • Internal Medicine Physician
  • San Diego, CA
National Provider Identifier
1881782647
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A41289 Issued in CA
Practice address
4537 College Avenue
San Diego, CA 92115-4010
Phone
(619) 265-0504
Fax
(619) 265-8358
NPI assigned
Oct 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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
Internal Medicine Physician 207R00000X A41289 CA Primary

Addresses

Primary practice location

4537 College Avenue
San Diego, CA 92115-4010

Mailing address

4537 College Avenue
San Diego, CA 92115-4010
Phone (619) 265-0504

Other identifiers 1

IdentifierTypeStateIssuer
00A412890MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20120425000117 CA Practitioner - Internal Medicine 1951563733 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4537 College Ave
San Diego, CA 92115-4010

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41289CAMDLicensed Psychiatric Technician
A41289CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
KND Development 59, LLC CurrentSince Aug 22, 2017 Accepting new patients
Neelakantan Ramineni MD, Inc. Internal Medicine CurrentSince Apr 25, 2012 Accepting new patients
KND Development 59 LLC CurrentSince Aug 22, 2017 Accepting new patients
KND Development 59 LLC Current Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Grossmont Hospital Corporation Past Accepting new patients
Scripps Health Past Accepting new patients

Locations

4940 El Cajon Blvd
San Diego, CA 92115
Phone (619) 543-4500

4537 College Ave
San Diego, CA 92115
Phone (619) 229-1895

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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.

Hospital & facility affiliations 3

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881782647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4537 COLLEGE AVENUE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154010",
            "telephone_number": "619-265-0504",
            "fax_number": "619-265-8358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4537 COLLEGE AVENUE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154010",
            "telephone_number": "619-265-0504",
            "fax_number": "619-265-8358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMINENI",
        "first_name": "NEELAKANTAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A41289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A412890",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.