DR. RAVIN DEFONSEKA (MD) – Internal Medicine Physician, NPI 1205413085

DR. RAVIN DEFONSEKA (MD) is a healthcare provider. based in Stamford, Connecticut. specializing in INTERNAL MEDICINE. They hold the professional credentials MD. They hold a License No. DR.0073481 (CO). The NPI Number for DR. RAVIN DEFONSEKA (MD) is 1205413085

Main info

Male
5 Years Of Experience
Accepts Medicare Assignment
Name
DR. RAVIN DEFONSEKA (MD)
NPI
1205413085
Phone
(203) 276-7147
Address
1 HOSPITAL PLZ
Enumeration Date
26 March 2021
Last Update Date
6 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3037885000
Graduation Year
2021 (5 years ago)
PAC ID
0244779080
Group Practice PAC ID
9133631351
Professional Enrollment ID
I20240826001169
Address ID
CO801132702EN501XXAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:5State licenses:1Digital endpointsOther names

3,448 INTERNAL MEDICINE in CT

Provider Addresses for DR. RAVIN DEFONSEKA (MD)

  • 1 HOSPITAL PLZ

    STAMFORD, CT 069023602

    Phone: (203) 276-7147

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-08-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240826001169IInternal MedicineCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06902)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9133631351View full group profile
NameSpecialtyState
Internal MedicineTX
Internal MedicineOR
Internal MedicineMI
Nurse PractitionerGA
Physician AssistantIN
Nurse PractitionerCO
H O S P I T A L I S TNC
Internal MedicineCO
Internal MedicineCA
Internal MedicineWY

Reviews

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Frequently asked questions

Can I cross-check DR. RAVIN DEFONSEKA (MD) using NPI 1205413085?
NPI 1205413085 belongs to DR. RAVIN DEFONSEKA (MD); compare other details if you need extra assurance.
Would DR. RAVIN DEFONSEKA (MD) appear as active to a payer?
You can treat DR. RAVIN DEFONSEKA (MD) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to DR. RAVIN DEFONSEKA (MD)?
DR. RAVIN DEFONSEKA (MD)'s specialty line reads Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with DR. RAVIN DEFONSEKA (MD)?
Directory geography for DR. RAVIN DEFONSEKA (MD) centers on Stamford, Connecticut.
Can I trust this NPI listing for DR. RAVIN DEFONSEKA (MD)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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