Individual provider Active NPI

Shalini Ravella, MD

  • Rheumatology Physician
  • Dyer, IN
National Provider Identifier
1942444724
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
01084878A Issued in IN
Practice address
919 Main St Ste 201
Dyer, IN 46311-3717
Phone
(219) 922-3002
Fax
(219) 922-3003
NPI assigned
Apr 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 036131441 IL
Rheumatology Physician 207RR0500X 01084878A IN Primary

Addresses

Primary practice location

919 Main St Ste 201
Dyer, IN 46311-3717

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other practice location 1

761 45th St Ste 103
Munster, IN 46321-2899
Phone (219) 922-3002

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sravella575124@Direct.FranciscanAlliance.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130125000298 IL Practitioner - Internal Medicine 0446404586 Reassigns benefits to 1 organization
I20201211002036 IN Practitioner - RheumatologyPractitioner - Internal Medicine 0446404586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

761 45TH St
Suite 103
Munster, IN 46321-2899
Phone (219) 922-3002

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network CurrentSince Dec 15, 2020 Accepting new patients
Endeavor Health Medical Group CurrentSince Oct 22, 2012 Accepting new patients
Franciscan Physician Network CurrentSince Dec 15, 2020 Accepting new patients
Endeavor Health Medical Group CurrentSince Oct 22, 2012 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

49 S Waukegan Rd
Ste 200
Deerfield, IL 60015
Phone (847) 945-4575

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

919 Main St
Ste 201
Dyer, IN 46311
Phone (219) 922-3002

1040 Sierra Dr
Ste 400
Greenwood, IN 46143
Phone (317) 528-4886

761 45th St
Ste 103
Munster, IN 46321
Phone (219) 922-3002

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

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 6

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": "1240531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1942444724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 MAIN ST STE 201",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463113717",
            "telephone_number": "219-922-3002",
            "fax_number": "219-922-3003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "761 45th St Ste 103",
            "address_purpose": "LOCATION",
            "city": "Munster",
            "state": "IN",
            "postal_code": "463212899",
            "country_code": "US",
            "telephone_number": "219-922-3002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAVELLA",
        "first_name": "SHALINI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-24",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "IL",
            "license": "036131441",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "IN",
            "license": "01084878A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sravella575124@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "919 Main St Ste 201",
            "city": "Dyer",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463113717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dyer, IN

Sources for this page

Verify at the official NPI Registry.