Provider Demographics
NPI:1720063761
Name:RANGANATHAN, CHINGLEPUT (MD)
Entity Type:Individual
Prefix:MR
First Name:CHINGLEPUT
Middle Name:
Last Name:RANGANATHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 932127
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-0008
Mailing Address - Country:US
Mailing Address - Phone:216-363-2524
Mailing Address - Fax:
Practice Address - Street 1:2351 E 22ND ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-3111
Practice Address - Country:US
Practice Address - Phone:216-363-2524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35 10 0088C207P00000X
OH35-100088207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000349348OtherANTHEM
OH000000381140OtherANTHEM
OH0396567Medicaid
OH001661451-0004OtherPENNSYLVANIA MEDICAID
OH000000028430OtherANTHEM
OH000000385522OtherANTHEM
OH000000383091OtherANTHEM
OH001661451-0003OtherPENNSYLVANIA MEDICAID
OHP00341493Medicare PIN
OH000000028430OtherANTHEM
OH000000385522OtherANTHEM
OH001661451-0004OtherPENNSYLVANIA MEDICAID
OH000000383091OtherANTHEM
OH000000349348OtherANTHEM
OH001661451-0003OtherPENNSYLVANIA MEDICAID
A77900Medicare UPIN
OH0396567Medicaid
OHRA4072613Medicare PIN