Active NPI
Rabindra R Tambyraja, M.D.
- Child & Adolescent Psychiatry Physician
- Minneapolis, MN
National Provider Identifier
1023226610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 53210
- Practice address
- 2450 Riverside Ave
Suite F256/2B West
Minneapolis, MN 55454-1450 - Phone
- (612) 273-9711
- Fax
- (612) 273-9779
- NPI assigned
- May 18, 2007
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | TC 57-01-0938 | OH | |
| Psychiatry Physician | 2084P0800X | 90024 | OH | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 53210 | MN | Primary |
Addresses
Primary practice location
2450 Riverside Ave
Suite F256/2B West
Minneapolis, MN 55454-1450
Mailing address
2450 Riverside Ave
Suite F256/2B West
Minneapolis, MN 55454-1450
Phone (612) 273-9711
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 90024 | OH | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childrens Health Care | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Children's Hospital
- Minneapolis, MN
- NPI 1881793750
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1293494400000",
"number": "1023226610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2450 RIVERSIDE AVE",
"address_2": "SUITE F256/2B WEST",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554541450",
"telephone_number": "612-273-9711",
"fax_number": "612-273-9779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2450 RIVERSIDE AVE",
"address_2": "SUITE F256/2B WEST",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554541450",
"telephone_number": "612-273-9711",
"fax_number": "612-273-9779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAMBYRAJA",
"first_name": "RABINDRA",
"middle_name": "R",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-18",
"last_updated": "2010-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "OH",
"license": "TC 57-01-0938",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "OH",
"license": "90024",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "MN",
"license": "53210",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.