SUGANTHI RAVINDRAN PHYSICIAN P.C
NPI 1912565490
Internal Medicine in Lake Ronkonkoma, NY
About Suganthi Ravindran Physician P.c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SUGANTHI RAVINDRAN PHYSICIAN P.C (NPI 1912565490) is a healthcare organization registered as an internal medicine in Lake Ronkonkoma, New York and active in the NPI registry since May 2019. The organization holds a CLIA Waiver certificate valid through January 26, 2027 and lists Suganthi Ravindran, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Suganthi Ravindran Physician P.c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Suganthi Ravindran Physician P.C, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 33D2211342
Suganthi Ravindran Physician PC · Lake Ronkonkoma, NYFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Suganthi Ravindran Physician P.C's NPI number?
The NPI number for Suganthi Ravindran Physician P.C is 1912565490. It was assigned to this organization in the NPPES registry on May 30, 2019.
Where is Suganthi Ravindran Physician P.C located?
Suganthi Ravindran Physician P.C is located at 709 Hawkins Ave Ste 1, Lake Ronkonkoma, NY 11779. The listed phone number is (631) 588-0880.
What is Suganthi Ravindran Physician P.C's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Suganthi Ravindran Physician P.C enrolled in Medicare?
Yes. Suganthi Ravindran Physician P.C is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Suganthi Ravindran Physician P.C?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Suganthi Ravindran Physician P.C. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Suganthi Ravindran Physician P.C hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 33D2211342) is associated with this NPI, valid through January 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Suganthi Ravindran Physician P.C was last updated on May 30, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Suganthi Ravindran Physician P.c · NPI 1912565490
Internal Medicine organization in Lake Ronkonkoma, New York. Organization record, active in the CMS NPPES registry since May 30, 2019.
## Identity
- **NPI:** 1912565490 (Entity type: Organization)
- **Enumerated:** May 30, 2019
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Organization subpart:** No
- **Authorized official:** Suganthi Ravindran, PRESIDENT
## Practice location
- **Address:** 709 HAWKINS AVE STE 1, Lake Ronkonkoma, NY 11779-2293
- **Phone:** (631) 588-0880 · **Fax:** (631) 588-0391
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Internal Medicine) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 30, 2019
- **Other identifiers:** Other 199922 (NY)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1912565490) · Data from the CMS NPPES public registry.