Ericka Ravenell, PHYSICIAN ASSISTANT

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

9660 Issued in GA

Practice address

111 E 210TH St
Bronx, NY 10467-2401

Phone

(718) 920-2985

NPI assigned

Apr 25, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, GA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Touro Un Col of Osteopathic Medicine, New York, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emory Medical Care Foundation IncGroup PAC ID 4981501814, 1,003 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grady Memorial Hospital Hospital, Atlanta, GA, CCN 110079

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eravenell51439@direct.emory.org

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.

• Emory Medical Care Foundation Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1063452381
  Medicare reassignment Care Compare group NPD
• The Emory Clinic Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1396798229
  Medicare reassignment NPD
• Coney Island Medical Practice Plan, P.C.

  • General Practice Physician
  • Brooklyn, NY
  • NPI 1386951762
  Medicare reassignment
• Fpa Hospital Based

  • Nuclear Medicine Physician
  • New York, NY
  • NPI 1629319413
  Medicare reassignment
• Fpa Hospital Based

  • Dermatopathology (Pathology) Physician
  • New York, NY
  • NPI 1841531795
  NPD
• Emory Medical Care Foundation Inc

  • Diagnostic Radiology Physician
  • Atlanta, GA
  • NPI 1225294739
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Grady Memorial Hospital Corporation

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1992799050
  Care Compare affiliation

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

{
    "created_epoch": "1461542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1992150270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "487 NOBLEWOOD DR",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302528963",
            "telephone_number": "914-424-0765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "718-920-2985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVENELL",
        "first_name": "ERICKA",
        "name_prefix": "Ms.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-25",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "019650",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "9660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Purnendu P Raval, PHARM D.
• Yaren Joeliz Ravel, LMHC
• Selma Anne Raven, MS. ED.
• Gladys Yaneth Raveneau, M.D.
• Tashi Raveneau, MSED
• Ethan Ravetch, M.D.
• Ravi Physician PC
• Ram Prasad Ravi, M.D.
• Srinivas M Ravi, M.D.
• Venkata Ramana Ravi, M.D.

• Medical Physician Assistant in Bronx, NY
• Providers in Bronx, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.