Revathy Ameeruddin, MD is a medicare enrolled "Physical Medicine & Rehabilitation" physician in Dyer, Indiana. She graduated from medical school in 1997 and has 28 years of diverse experience with area of expertise as Physical Medicine And Rehabilitation. She is a member of the group practice Franciscan Physician Network and her current practice location is
24 Joliet St Ste 101, Dyer, Indiana. You can reach out to her office (for appointments etc.) via phone at
(219) 864-2059.
Revathy Ameeruddin is licensed to practice in Indiana (license number 01061500A) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1588730063.
Physician's Profile
| Full Name | Revathy Ameeruddin |
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| Gender | Female |
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| Speciality | Physical Medicine And Rehabilitation |
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| Experience | 28 Years |
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| Location | 24 Joliet St Ste 101, Dyer, Indiana |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Revathy Ameeruddin graduated from medical school in 1997
NPI Data:
- NPI Number: 1588730063
- Provider Enumeration Date: 11/28/2006
- Last Update Date: 02/15/2023
Medicare PECOS Information:
- PECOS PAC ID: 4880589043
- Enrollment ID: I20090310000322
Medical Identifiers
Medical identifiers for Revathy Ameeruddin such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1588730063 | NPI | - | NPPES |
| 00A844330 | Medicaid | CA | |
| 200943400 | Medicaid | IN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208100000X | Physical Medicine & Rehabilitation | 010-81500A (Indiana) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | A84433 (California) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | 01061500A (Indiana) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Franciscan Physician Network | 3072790682 | 1041 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Revathy Ameeruddin allows following entities to bill medicare on her behalf.
| Entity Name | Franciscan Physician Network |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1225327984
PECOS PAC ID: 3072790682
Enrollment ID: O20110608000486 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Revathy Ameeruddin is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Revathy Ameeruddin, MD
Po Box 781076,
Detroit, MI 48278-1076
Ph: (317) 528-4800 | Revathy Ameeruddin, MD
24 Joliet St Ste 101,
Dyer, IN 46311-1705
Ph: (219) 864-2059 |
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