Individual provider Active NPI

Naseem Ravanbakhsh, MD

  • Pediatrics Physician
  • Chicago, IL
National Provider Identifier
1972032290
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
125070275 Issued in IL
Practice address
225 E Chicago Ave
Chicago, IL 60611-2991
Phone
(312) 227-4000
NPI assigned
Jun 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X V0517 TX
Pediatric Gastroenterology Physician 2080P0206X 036.164495 IL
Pediatrics Physician 208000000X 125070275 IL Primary

Addresses

Primary practice location

225 E Chicago Ave
Chicago, IL 60611-2991

Mailing address

6701 Fannin St
Houston, TX 77030-2608

Other practice location 1

6621 Fannin St
Houston, TX 77030-2358
Phone (832) 824-1000

Other practice location 2

4650 W Sunset Blvd
Los Angeles, CA 90027-6062
Phone (323) 660-2450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240603001159 TX Practitioner - Pediatric MedicinePractitioner - Gastroenterology 9335681675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Gastroenterology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Childrens Physician GroupGroup PAC ID 4385722081, 661 clinicians

Practice addresses (Care Compare)

8611 N Mopac Expy
Austin, TX 78759-8319
Phone (832) 824-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125070275ILMDPediatrics Physician
036.164495ILMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Children'S Physician Group Pediatrics CurrentSince May 14, 2024 Accepting new patients

Locations

8611 N Mopac Expy
Austin, TX 78759
Phone (713) 816-1250

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

6621 Fannin St
Houston, TX 77030
Phone (832) 824-1866

6651 Main St
Va Hospital, TX 77030
Phone (832) 826-3000

Interoperability endpoints

  • Direct secure messaging: nravanbakhsh540991@prddirect.texaschildrens.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1972032290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112991",
            "telephone_number": "312-227-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6621 Fannin St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302358",
            "country_code": "US",
            "telephone_number": "832-824-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4650 W Sunset Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900276062",
            "country_code": "US",
            "telephone_number": "323-660-2450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAVANBAKHSH",
        "first_name": "NASEEM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-08",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "TX",
            "license": "V0517",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "IL",
            "license": "036.164495",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125070275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.