Ravindrakumar Gangadhariah, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

36638 Issued in IA

Practice address

635 W Corona Ave Ste 105
Pueblo, CO 81004-1209

Phone

(719) 824-1591

Fax

(719) 312-5549

NPI assigned

Jun 6, 2006

Last updated

Oct 26, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Dr. Ravi Kumar Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Rab Dermatology LLC

  • Dermatology Physician
  • Pueblo, CO
  • NPI 1134352677
  Authorized official Same address or phone
• Ashok PC

  dba Academy Allergy & Asthma

  • Specialist
  • Pueblo, CO
  • NPI 1790819456
  NPD (past)
• Southern Medical Partners, LLC

  • Emergency Medicine Physician
  • Hazard, KY
  • NPI 1538109962
  NPD (past)

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792972800000",
    "number": "1922047869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 W CORONA AVE STE 105",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810041209",
            "telephone_number": "719-824-1591",
            "fax_number": "719-312-5549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 W CORONA AVE STE 105",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810041209",
            "telephone_number": "719-824-1591",
            "fax_number": "719-312-5549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANGADHARIAH",
        "first_name": "RAVINDRAKUMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2026-10-26",
        "certification_date": "2026-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036115671",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036-115671",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IA",
            "license": "36638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAVI",
            "last_name": "KUMAR",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Tina Gallegos
• Venice Gallegos, M.A.
• Anne Galvin-Soto
• Maryann Cecelia Katherine Gamble, M.D.
• Ganapathy Bala MD LLC (Allergy and Asthma Center)
• Tim Joseph Gangel, MPT
• Lori Ann Ganni, MT.0020842
• Jacy Gansz-Torres, FNP
• Erin Amanda Gansz, LPC
• Kari Dawn Gant, LPC

• Dermatology Physician in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Dermatology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2026; 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.