Individual provider Active NPI

Raja A. Nazir, M.D.

  • Interventional Cardiology Physician
  • Wilmington, OH
National Provider Identifier
1003871963
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
35070473 Issued in OH
Practice address
630 W Main St Ste 105
Wilmington, OH 45177-2171
Phone
(937) 283-9888
NPI assigned
Apr 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 35-07-0473N OH
Interventional Cardiology Physician 207RI0011X 35070473 OH Primary

Addresses

Primary practice location

630 W Main St Ste 105
Wilmington, OH 45177-2171

Mailing address

540 Lincoln Park Blvd
Suite 200
Dayton, OH 45429-6401
Phone (937) 298-8058

Other practice location 1

540 Lincoln Park Blvd
Suite 200
Kettering, OH 45429-6401
Phone (937) 298-8058

Other identifiers 1

IdentifierTypeStateIssuer
2321080MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050802000131 OH Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 6507894409 Reassigns benefits to 2 organizations
I20231102003154 MI Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 6507894409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians
Mymichigan Medical Center AlpenaGroup PAC ID 8527969922, 97 clinicians

Practice addresses (Care Compare)

1141 N Monroe Dr
Xenia, OH 45385-1619
Phone (937) 490-2270

1380 E Stroop Rd
Kettering, OH 45429-4926
Phone (937) 293-3486

1501 W Chisholm St
Alpena, MI 49707-1401
Phone (989) 356-7390

3535 Pentagon Blvd
Beavercreek, OH 45431-1705

3535 Pentagon Park Blvd
Suite 400
Dayton, OH 45431-1705
Phone (937) 490-2264

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8646

4403 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 433-5309

4441 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 298-7751

540 Lincoln Park Blvd
Suite 200
Dayton, OH 45429-6403
Phone (937) 298-8058

7677 Yankee St
Suite 140
Dayton, OH 45459-3475
Phone (866) 224-9472

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting35
Leg revascularization (restoring blood flow)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35070473OHMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kettering Independent Medical Group Inc Cardiovascular Disease CurrentSince Dec 29, 2022 Accepting new patients
Mary Rutan Hospital CurrentSince Nov 1, 2020 Accepting new patients
Mymichigan Medical Center Alpena Current Accepting new patients
Mary Rutan Hospital Current Accepting new patients
Mymichigan Medical Center Alpena Cardiovascular Disease CurrentSince Nov 1, 2023 Accepting new patients
Mary Rutan Hospital CurrentSince Nov 1, 2020 Accepting new patients
Mary Rutan Hospital Past Accepting new patients
Kettering Medical Center Past Accepting new patients

Locations

1501 W Chisholm St
Alpena, MI 49707
Phone (989) 356-7000

460 Long Rapids Plz
Alpena, MI 49707
Phone (989) 356-0141

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

3535 Pentagon Blvd
Ste 320
Beavercreek, OH 45431
Phone (937) 490-2270

1134 N Main St
Ste 2500
Bellefontaine, OH 43311
Phone (937) 292-3494

205 E Palmer Rd
Bellefontaine, OH 43311
Phone (937) 592-4015

3535 Southern Blvd
#1E
Kettering, OH 45429
Phone (937) 395-8124

540 Lincoln Park Blvd
Ste 200
Kettering, OH 45429
Phone (937) 293-1117

3535 Southern Blvd
Kettering, OH 45429
Phone (937) 298-1221

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

4000 Miamisburg Centerville Rd
Ste 100
Miamisburg, OH 45342
Phone (937) 643-9939

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

825 N Main St
Ste 130
Springboro, OH 45066
Phone (937) 401-7583

Networks

  • devoted network organization-2d523d8e-e8f9-454a-bcd3-333df65bdbe8
  • devoted network organization-9f3dfbd3-4aa6-4c92-8e71-9c4ed35ce037
  • OH PPO
  • devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6
  • KY PPO
  • devoted network organization-8ee96498-f86e-45f6-9fc9-a0f06c1636f9
  • KY PPO C-SNP

Interoperability endpoints

  • Direct secure messaging: ranazir@yourcarecommunity.org
  • Direct secure messaging: rnazir186630@direct.ketteringhealth.org
  • Direct secure messaging: rnazir142830@mymichiganhealth.midirect.net

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1003871963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 LINCOLN PARK BLVD",
            "address_2": "SUITE 200",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454296401",
            "telephone_number": "937-298-8058",
            "fax_number": "937-298-5638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 W MAIN ST STE 105",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451772171",
            "telephone_number": "937-283-9888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "540 Lincoln Park Blvd",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454296401",
            "country_code": "US",
            "telephone_number": "937-298-8058",
            "fax_number": "937-298-5638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAZIR",
        "first_name": "RAJA",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35-07-0473N",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "OH",
            "license": "35070473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2321080",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, OH

Sources for this page

Verify at the official NPI Registry.