Individual provider Active NPI

Gouri Ramesh, M.D.

  • Pediatric Adolescent Medicine Physician
  • Detroit, MI
National Provider Identifier
1982634119
Registry record updated Jan 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
4301064864 Issued in MI
Practice address
7900 Kercheval St
Detroit, MI 48214-2439
Phone
(313) 921-5500
Fax
(313) 921-5530
NPI assigned
Jul 4, 2006
Last updated
Jan 29, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 4301064864 MI Primary

Addresses

Primary practice location

7900 Kercheval St
Detroit, MI 48214-2439

Mailing address

7900 Kercheval St
Detroit, MI 48214-2439
Phone (313) 921-5500

Other identifiers 1

IdentifierTypeStateIssuer
GR064864OtherMIBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20130702000793 MI Practitioner - Pediatric Medicine 9335389964 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301064864MIMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Detroit Community Health Connection, Inc CurrentSince May 10, 2013 Accepting new patients
Detroit Community Health Connection, Inc. CurrentSince May 10, 2013 Accepting new patients

Locations

13901 E Jefferson Ave
Detroit, MI 48215
Phone (313) 821-2591

7900 Kercheval St
Detroit, MI 48214
Phone (313) 921-5500

Interoperability endpoints

  • Direct secure messaging: gouri.ramesh@dchc.directbygreenway.com
  • Direct secure messaging: gramesh@direct.dmc.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517184000000",
    "number": "1982634119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 KERCHEVAL ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482142439",
            "telephone_number": "313-921-5500",
            "fax_number": "313-921-5530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 KERCHEVAL ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482142439",
            "telephone_number": "313-921-5500",
            "fax_number": "313-921-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMESH",
        "first_name": "GOURI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2018-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MI",
            "license": "4301064864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "GR064864",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.