Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ram Gautam Gorantla, MD

Individual provider Internal Medicine Physician · NPI 1114443918

Ram Gautam Gorantla, MD is an Internal Medicine in Phoenix, Arizona. Qualified in 2015, 11 years ago. Practices with Banner - University Hospital Based Physicians LLC, a 347-clinician group and accepts Medicare assignment. Licensed in Arizona and Nebraska.

Years since qualifying
11
Licensed in
AZ, NE
In the registry since
2017
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone: (602) 839-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 64275 (AZ)
Internal Medicine Physician Taxonomy 207R00000X · Licence 7984 (NE)

Record details

NPI number1114443918
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 14, 2017
Last updated in NPPESSeptember 14, 2021
Certification dateSeptember 14, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Also practisesHOSPITALIST
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Banner - University Hospital Based Physicians Llc — 347 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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