Individual provider Active NPI

Manikandan Rajagopal, M.D.

  • Hospitalist Physician
  • Rogers, AR
National Provider Identifier
1053575597
Registry record updated Nov 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
E-8770 Issued in AR
Practice address
2710 S Rife Medical LN
Rogers, AR 72758-1452
Phone
(479) 338-8000
Fax
(479) 338-2383
NPI assigned
Jul 14, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X E-8770 AR Primary
Internal Medicine Physician 207R00000X E-8770 AR

Addresses

Primary practice location

2710 S Rife Medical LN
Rogers, AR 72758-1452

Mailing address

2710 S Rife Medical LN
Rogers, AR 72758-1452
Phone (479) 338-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20140917000784 AR Practitioner - Internal Medicine 3072783406 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2710 S Rife Medical LN
Rogers, AR 72758-1452
Phone (479) 338-8000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Arkansas Clinic Charitable Foundation, Inc. Current Accepting new patients
Mercy Health Northwest Arkansas Communities Hospitalist CurrentSince Nov 14, 2016 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Nov 14, 2016 Accepting new patients
Northeast Arkansas Clinic Charitable Foundation, Inc. CurrentSince Oct 15, 2014 Accepting new patients
Northeast Arkansas Clinic Charitable Foundation, Inc. CurrentSince Oct 15, 2014 Accepting new patients
Inpatient Consultants of Missouri Inc Internal Medicine Past Accepting new patients
Mercy Hospital Rogers Past Accepting new patients
Mercy Health Northwest Arkansas Communities Past Accepting new patients
SSM Health Care St. Louis Internal Medicine Past Accepting new patients

Locations

3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100

1111 Windover Rd
Jonesboro, AR 72401
Phone (870) 935-5432

2710 S Rife Medical Ln
Rogers, AR 72758
Phone (479) 338-8000

Organizations & group practices 9

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 2

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": "1215993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478822400000",
    "number": "1053575597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 S RIFE MEDICAL LN",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581452",
            "telephone_number": "479-338-8000",
            "fax_number": "479-338-2383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 S RIFE MEDICAL LN",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581452",
            "telephone_number": "479-338-8000",
            "fax_number": "479-338-2383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJAGOPAL",
        "first_name": "MANIKANDAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-14",
        "last_updated": "2016-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AR",
            "license": "E-8770",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-8770",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.