Individual provider Active NPI

Robert N Raju, M.D.

  • Medical Oncology Physician
  • Dayton, OH
National Provider Identifier
1093765158
Registry record updated Oct 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
DR.0055943 Issued in CO
Practice address
1191 Walnut Valley LN
Dayton, OH 45458-9583
Phone
(937) 885-3582
NPI assigned
May 11, 2006
Last updated
Oct 23, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 35057684 OH
Medical Oncology Physician 207RX0202X DR.0055943 CO Primary

Addresses

Primary practice location

1191 Walnut Valley LN
Dayton, OH 45458-9583

Mailing address

1191 Walnut Valley LN
Dayton, OH 45458-9583
Phone (937) 885-3582

Other identifiers 1

IdentifierTypeStateIssuer
0730329MedicaidOH

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
35057684OHMDHematology & Oncology Physician
DR.0055943COMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dayton Oncology & Hematology, PA Hematology & Oncology Past Accepting new patients
Greater Dayton Cancer Center Pharmacy PastSince Jan 1, 1995 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445558400000",
    "number": "1093765158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1191 WALNUT VALLEY LN",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454589583",
            "telephone_number": "937-885-3582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1191 WALNUT VALLEY LN",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454589583",
            "telephone_number": "937-885-3582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJU",
        "first_name": "ROBERT",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2015-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "OH",
            "license": "35057684",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "CO",
            "license": "DR.0055943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0730329",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2015; 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.