Individual provider Active NPI

Kavitha Pandy Raj, MD

  • Medical Oncology Physician
  • Pleasanton, CA
National Provider Identifier
1053450767
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
A93219 Issued in CA
Practice address
5725 W Las Positas Blvd Ste 100a
Pleasanton, CA 94588-4054
Phone
(925) 734-8130
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) Physician 207RH0000X A93219 CA
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X A93219 CA
Internal Medicine Physician 207R00000X A93219 CA
Hematology & Oncology Physician 207RH0003X A93219 CA
Medical Oncology Physician 207RX0202X A93219 CA Primary

Addresses

Primary practice location

5725 W Las Positas Blvd Ste 100a
Pleasanton, CA 94588-4054

Mailing address

5725 W Las Positas Blvd Ste 100a
Pleasanton, CA 94588-4054
Phone (925) 734-8130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20100621000251 CA Practitioner - Hematology/OncologyPractitioner - Internal Medicine 7618909367 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Stanford Health CareGroup PAC ID 6709797491, 3,152 clinicians

Practice addresses (Care Compare)

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

5555 W Las Positas Blvd
Pleasanton, CA 94588-4000
Phone (925) 847-3000

5725 W Las Positas Blvd
Pleasanton, CA 94588-4007

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A93219CAMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stanford Health Care Internal Medicine CurrentSince Feb 6, 2020 Accepting new patients
University Healthcare Alliance Internal Medicine CurrentSince Nov 30, 2016 Accepting new patients
Stanford Health Care Internal Medicine Current Accepting new patients
Stanford Health Care CurrentSince Feb 6, 2020 Accepting new patients
James R. Cohen MD Medical Corporation Hematology & Oncology PastSince Mar 31, 2014 Accepting new patients
University Healthcare Alliance PastSince Apr 21, 2024 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

50 E Hamilton Ave
Ste 280
Campbell, CA 95008
Phone (408) 227-2646

1300 Crane St
Menlo Park, CA 94025
Phone (510) 785-5000

5725 W Las Positas Blvd
Ste 100
Pleasanton, CA 94588

5725 W Las Positas Blvd
Ste 101
Pleasanton, CA 94588

4725 1st St
Ste 100
Pleasanton, CA 94566
Phone (925) 462-7060

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: kraj126743@direct.stanfordhealthcare.org

Organizations & group practices 7

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 10

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1053450767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5725 W LAS POSITAS BLVD STE 100A",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945884054",
            "telephone_number": "925-734-8130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5725 W LAS POSITAS BLVD STE 100A",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945884054",
            "telephone_number": "925-734-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJ",
        "first_name": "KAVITHA",
        "middle_name": "PANDY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "CA",
            "license": "A93219",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "CA",
            "license": "A93219",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A93219",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A93219",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "CA",
            "license": "A93219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

Verify at the official NPI Registry.