Individual provider Active NPI

Rajden Kutelia, M.D.

  • Internal Medicine Physician
  • Norfolk, VA
National Provider Identifier
1013993906
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101253361 Issued in VA
Practice address
600 Gresham Dr FL 5
Norfolk, VA 23507-1904
Phone
(757) 388-3198
Fax
(757) 388-4242
NPI assigned
Dec 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 43232 WA
Hospitalist Physician 208M00000X 0101253361 VA
Internal Medicine Physician 207R00000X 0101253361 VA Primary

Addresses

Primary practice location

600 Gresham Dr FL 5
Norfolk, VA 23507-1904

Mailing address

600 Gresham Dr FL 5
Norfolk, VA 23507-1904
Phone (757) 388-3198

Other practice location 1

1706 Washington Way
Longview, WA 98632-2952
Phone (360) 423-9580

Other identifiers 1

IdentifierTypeStateIssuer
8399297MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20130304000395 VA Practitioner - Internal MedicinePractitioner - Hospitalist 7618947649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

600 Gresham Dr
Norfolk, VA 23507-1904

830 Kempsville Rd
2B223
Norfolk, VA 23502-3920
Phone (757) 261-8860

850 Kempsville Rd
Norfolk, VA 23502-3920

Hospital & facility affiliations

  • Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007
  • Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101253361VAMDInternal Medicine Physician
43232WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group Internal Medicine CurrentSince Feb 5, 2013 Accepting new patients
Midwest Doctors Group, LLC Hospitalist Past Accepting new patients

Locations

600 Gresham Dr
Fl 5
Norfolk, VA 23507
Phone (757) 388-3198

600 Gresham Dr
Ste 5B
Norfolk, VA 23507
Phone (757) 388-3198

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

Organizations & group practices 2

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 3

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": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1013993906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR FL 5",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-388-3198",
            "fax_number": "757-388-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR FL 5",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-388-3198",
            "fax_number": "757-388-4242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1706 Washington Way",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "WA",
            "postal_code": "986322952",
            "country_code": "US",
            "telephone_number": "360-423-9580",
            "fax_number": "360-577-6230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUTELIA",
        "first_name": "RAJDEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "43232",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0101253361",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101253361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8399297",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.