Individual provider Active NPI

Rajappa Ekambaram, M.D.

  • Family Medicine Physician
  • Huntsville, AL
National Provider Identifier
1982659702
Registry record updated Apr 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
AL10375 Issued in AL
Practice address
4717 University Dr NW Ste 109
Huntsville, AL 35816-3460
Phone
(256) 890-8700
Fax
(256) 890-8989
NPI assigned
May 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X AL10375 AL Primary

Addresses

Primary practice location

4717 University Dr NW Ste 109
Huntsville, AL 35816-3460

Mailing address

4717 University Dr NW Ste 109
Huntsville, AL 35816-3460
Phone (256) 890-8700

Other identifiers 3

IdentifierTypeStateIssuer
51009976OtherALBLUE CROSS BLUE SHIELD
51510738OtherALBC PROVIDER NUMBER
51009975OtherALBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20050215000593 AL Practitioner - Family PracticePractitioner - Emergency Medicine 5496707788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4296 University Dr NW
Huntsville, AL 35816-3006
Phone (256) 890-8700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AL10375ALMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fayette Medical Center Past Accepting new patients
Correct Care, Inc. Past Accepting new patients

Organizations & group practices 3

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 1

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586390400000",
    "number": "1982659702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4717 UNIVERSITY DR NW STE 109",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358163460",
            "telephone_number": "256-890-8700",
            "fax_number": "256-890-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4717 UNIVERSITY DR NW STE 109",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358163460",
            "telephone_number": "256-890-8700",
            "fax_number": "256-890-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKAMBARAM",
        "first_name": "RAJAPPA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "AL10375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51009976",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC PROVIDER NUMBER",
            "identifier": "51510738",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51009975",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.