Ravali Bandaru, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

207012 Issued in LA

Practice address

2308 E Main St
Suite G
New Iberia, LA 70560-4041

Phone

(337) 367-2001

Fax

(337) 365-3050

NPI assigned

Jul 29, 2014

Last updated

Sep 13, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Pediatric Group of Acadiana, LLC

  • Specialist
  • Lafayette, LA
  • NPI 1265499628
  Medicare reassignment NPD
• Pediatric Group of Acadiana LLC

  dba Kaplan Family Care Clinic

  • Rural Health Clinic/Center
  • Kaplan, LA
  • NPI 1922619238
  NPD
• Pediatric Group of Acadiana, LLC

  dba St. Martinville Maternal-Child Clinic

  • Rural Health Clinic/Center
  • Saint Martinville, LA
  • NPI 1922283225
  NPD
• Hospital Service District No. 1 of Iberia Parish

  dba Iberia Medical Center

  • General Acute Care Hospital
  • New Iberia, LA
  • NPI 1285601088
  NPD (past)

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

{
    "created_epoch": "1406592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1891103222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 YOUNGSVILLE HWY",
            "address_2": "SUITE 100",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085173",
            "telephone_number": "337-330-0031",
            "fax_number": "337-330-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2308 E MAIN ST",
            "address_2": "SUITE G",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705604041",
            "telephone_number": "337-367-2001",
            "fax_number": "337-365-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANDARU",
        "first_name": "RAVALI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-29",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "207012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2372874",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Antoine Todd Babineaux, DDS
• Phyllis Theresa Babineaux, MSW, GSW, LCSW
• Stephanie C Badon, APRN-BC
• Baker Suraj, Inc
• Vina S Baker, MD
• Patrick Shawn Baquet, M.D.
• Ashley Barabin
• Marcus James Barras, NP
• Basic Home Care Services Inc
• Mia Marie Batiste

• Pediatrics Physician in New Iberia, LA
• Providers in New Iberia, LA by specialty
• Pediatrics Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.