Individual provider Active NPI

Ram Niwas Bishnoi, MD

  • Pediatric Cardiology Physician
  • Jacksonville, FL
National Provider Identifier
1972759157
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
ME165205 Issued in FL
Practice address
841 Prudential Dr Ste 280
Jacksonville, FL 32207-8350
Phone
(904) 202-8550
Fax
(904) 393-7808
NPI assigned
Aug 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME165205 FL
Pediatric Cardiology Physician 2080P0202X MD443172 PA
Pediatric Cardiology Physician 2080P0202X ME165205 FL Primary
Pediatrics Physician 208000000X MT193347 PA

Addresses

Primary practice location

841 Prudential Dr Ste 280
Jacksonville, FL 32207-8350

Mailing address

PO Box 746645
Atlanta, GA 30374-6645
Phone (904) 202-2092

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, FL2 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
I20150924001967 PA Practitioner - Pediatric Medicine 1456669480 Reassigns benefits to 3 organizations
I20231129000640 FL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 1456669480 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT193347PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Current Accepting new patients
Caring Community Health Center CurrentSince Nov 17, 2019 Accepting new patients
Baptist Specialty Physicians Inc Pediatric Cardiology CurrentSince Dec 15, 2023 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Jun 18, 2021 Accepting new patients
Guthrie Medical Group, P.C. Current Accepting new patients
Baptist Specialty Physicians Inc Pediatric Cardiology CurrentSince Nov 26, 2023 Accepting new patients
Caring Community Health Center CurrentSince Nov 17, 2019 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Jun 18, 2021 Accepting new patients
Geisinger Clinic CurrentSince Oct 2, 2015 Accepting new patients
Geisinger Clinic CurrentSince Oct 2, 2015 Accepting new patients
The Nemours Foundation Past Accepting new patients

Locations

841 Prudential Dr
Ste 280
Jacksonville, FL 32207
Phone (904) 202-8290

2418 E Plaza Dr
Tallahassee, FL 32308
Phone (850) 629-4861

100 N Academy Ave
Danville, PA 17822

426 Airport Rd
Ste 125
Hazle Township, PA 18202
Phone (570) 829-2621

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

Interoperability endpoints

  • Direct secure messaging: rbishnoi158400@direct-guthrie.org
  • Direct secure messaging: rbishnoi159681@direct.nemours.org

Organizations & group practices 11

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": "1218067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1972759157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746645",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746645",
            "telephone_number": "904-202-2092",
            "fax_number": "904-376-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 PRUDENTIAL DR STE 280",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078350",
            "telephone_number": "904-202-8550",
            "fax_number": "904-393-7808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISHNOI",
        "first_name": "RAM",
        "middle_name": "NIWAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-07",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME165205",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "PA",
            "license": "MD443172",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "FL",
            "license": "ME165205",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT193347",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.