Individual provider Active NPI

Venkatesan Ravishankar, M.D.

  • Internal Medicine Physician
  • Canton, OH
National Provider Identifier
1942310263
Registry record updated Feb 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35 07262R Issued in OH
Practice address
1455 Harrison Ave NW
Suite 108
Canton, OH 44708-2621
Phone
(330) 455-4999
Fax
(330) 455-4975
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2010

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 35 07262R OH Primary

Addresses

Primary practice location

1455 Harrison Ave NW
Suite 108
Canton, OH 44708-2621

Mailing address

1455 Harrison Ave NW
Suite 108
Canton, OH 44708-2621
Phone (330) 455-4999

Other identifiers 2

IdentifierTypeStateIssuer
9373391OtherGROUP MEDICARE
2035541MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20080213000423 OH Practitioner - Internal Medicine 5597848622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4503 Fulton Dr NW
Suite a
Canton, OH 44718-2331
Phone (330) 455-4999

Hospital & facility affiliations

  • Mercy Medical Center Hospital, Canton, OH, CCN 360070
  • Aultman Hospital Hospital, Canton, OH, CCN 360084

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35 07262ROHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stark Primary Care, LLC Internal Medicine CurrentSince Nov 27, 2007 Accepting new patients
Premier Medical Group, Inc Internal Medicine Past Accepting new patients
Dorai T Rajan M D Inc Internal Medicine Past Accepting new patients
Cleveland Clinic Mercy Hospital Past Accepting new patients

Locations

1455 Harrison Ave NW
Ste 108
Canton, OH 44708
Phone (330) 455-4999

4503 Fulton Dr NW
Ste A
Canton, OH 44718
Phone (330) 455-4999

4612 Tuscarawas St W
Canton, OH 44708
Phone (216) 449-8801

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DDEBCA/Endpoint/DDEBCA

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264982400000",
    "number": "1942310263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 HARRISON AVE NW",
            "address_2": "SUITE 108",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447082621",
            "telephone_number": "330-455-4999",
            "fax_number": "330-455-4975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 HARRISON AVE NW",
            "address_2": "SUITE 108",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447082621",
            "telephone_number": "330-455-4999",
            "fax_number": "330-455-4975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVISHANKAR",
        "first_name": "VENKATESAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2010-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35 07262R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "9373391",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2035541",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.