NPIMap

Individual provider Active NPI

Raji Venkat, M.D.

  • Internal Medicine Physician
  • Henderson, NV
National Provider Identifier
1093712986
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
8906 Issued in NV
Practice address
10001 S Eastern Ave Ste 101
Henderson, NV 89052-3908
Phone
(702) 616-5870
Fax
(702) 616-5895
NPI assigned
Jul 7, 2005
Last updated
Oct 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 8906 NV Primary

Addresses

Primary practice location

10001 S Eastern Ave Ste 101
Henderson, NV 89052-3908

Mailing address

PO Box 33269
Phoenix, AZ 85067-3269
Phone (602) 406-4786

Other names 1

  • Raji Venkatasubra Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040927000178 NV Practitioner - Internal Medicine 1850360934 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dignity Health Medical Group Nevada LLCGroup PAC ID 1254571896, 127 clinicians

Practice addresses (Care Compare)

10001 S Eastern Ave
Suite 101
Henderson, NV 89052-3908
Phone (702) 616-5870

8689 W Charleston Blvd
Suite 105
Las Vegas, NV 89117-5485
Phone (702) 304-5900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.21 of 100Reported as group
Quality
63.87
Promoting interoperability
96
Improvement activities
40
Cost
76.83

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Group Nevada, LLC CurrentSince Jan 17, 2015 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

10001 S Eastern Ave
Ste 101
Henderson, NV 89052
Phone (702) 616-5870

8689 W Charleston Blvd
Ste 105
Las Vegas, NV 89117
Phone (702) 304-5900

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1093712986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33269",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850673269",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10001 S EASTERN AVE STE 101",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523908",
            "telephone_number": "702-616-5870",
            "fax_number": "702-616-5895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENKAT",
        "first_name": "RAJI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "8906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAJI",
            "last_name": "VENKATASUBRA",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.