Active NPI
Rajden Kutelia, M.D.
- Internal Medicine Physician
- Norfolk, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 0101253361
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8399297 | Medicaid | WA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
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
- Sentara Princess Anne Hospital
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.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101253361 | VA | MD | Internal Medicine Physician |
| 43232 | WA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sentara Medical Group | Internal Medicine | Current | 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.
-
- Sports Medicine (Family Medicine) Physician
- Independence, MO
- NPI 1841462314
Hospitalist
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Norfolk, VA
- NPI 1437119310
-
- General Acute Care Hospital
- Virginia Beach, VA
- NPI 1528028396
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.