Individual provider Active NPI

Shanker Raja, M.D.

  • Nuclear Imaging & Therapy Physician
  • Burlington, MA
National Provider Identifier
1083710503
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Imaging & Therapy PhysicianTaxonomy code 207UN0902X
License
223237 Issued in MA
Practice address
Lahey Clinic
41 Mall Road
Burlington, MA 01805-0001
Phone
(781) 744-5100
Fax
(781) 744-5215
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Imaging & Therapy Physician 207UN0902X 223237 MA Primary

Addresses

Primary practice location

Lahey Clinic
41 Mall Road
Burlington, MA 01805-0001

Mailing address

32 Sullivan St
Lexington, MA 02420-1115
Phone (781) 744-2275

Other identifiers 1

IdentifierTypeStateIssuer
2096170MedicaidOH

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

LicenseStateTypeSpecialty
223237MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lahey Clinic, Inc Past Accepting new patients
Clinic Physician Services Co. LLC Past Accepting new patients
Lahey Clinic, Inc. 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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1083710503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 SULLIVAN ST",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024201115",
            "telephone_number": "781-744-2275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LAHEY CLINIC",
            "address_2": "41 MALL ROAD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018050001",
            "telephone_number": "781-744-5100",
            "fax_number": "781-744-5215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJA",
        "first_name": "SHANKER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207UN0902X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Imaging & Therapy",
            "state": "MA",
            "license": "223237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2096170",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.