Individual provider Active NPI

Satyanarayana Ganapathi Raju, D.O., PH.D

  • Family Medicine Physician
  • Danville, IL
National Provider Identifier
1083623581
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02002114A Issued in IN
Practice address
806 Sheridan St
Danville, IL 61832-3718
Phone
(217) 442-3010
Fax
(217) 442-3155
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 02002114A IN Primary

Addresses

Primary practice location

806 Sheridan St
Danville, IL 61832-3718

Mailing address

806 Sheridan St
Danville, IL 61832-3718
Phone (217) 442-3010

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)
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 Osteopathy, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Physicians of Indiana LLC Current Accepting new patients
Norton Enterprises, Inc. Past Accepting new patients
Community Medical Associates, Inc. Family Medicine Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1083623581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 SHERIDAN ST",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618323718",
            "telephone_number": "217-442-3010",
            "fax_number": "217-442-3155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 SHERIDAN ST",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618323718",
            "telephone_number": "217-442-3010",
            "fax_number": "217-442-3155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJU",
        "first_name": "SATYANARAYANA",
        "middle_name": "GANAPATHI",
        "name_prefix": "Dr.",
        "credential": "D.O., PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02002114A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.