Provider Demographics
NPI:1013934058
Name:RAMINENI, GOPALA
Entity type:Individual
Prefix:
First Name:GOPALA
Middle Name:
Last Name:RAMINENI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 HOT METAL ST
Mailing Address - Street 2:QUANTUM 1 N431
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-2348
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:850 HOSPITAL RD
Practice Address - Street 2:SUITE 1300
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3662
Practice Address - Country:US
Practice Address - Phone:724-349-9444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD429838207RH0003X
METD061067207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEAS OF 10/16/06OtherMARTINS POINT
ME1372531OtherAETNA HMO
PA2092175OtherHIGHMARK BLUE SHIELD
ME5023749OtherCIGNA
MEI39347OtherHARVARD PILGRIM
PA0016480750038Medicaid
PA0016480750041Medicaid
ME098123OtherANTHEM
PA11527877OtherCAQH
MEAS OF 8/7/06OtherBENEFIT SERVICES
ME258742504OtherUNITED HEALTHCARE
ME7344872OtherAETNA NON HMO
PA0016480750038Medicaid
I39347Medicare UPIN
PA153822F6VMedicare PIN
ME0000380001Medicare PIN