Individual provider Active NPI

Venkata Nakta Raju, MD

  • Neonatal-Perinatal Medicine Physician
  • Temple, TX
National Provider Identifier
1093788481
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
L7126 Issued in TX
Practice address
1901 SW H K Dodgen Loop
Temple, TX 76502-1814
Phone
(254) 935-4000
Fax
(254) 935-4111
NPI assigned
Feb 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X L7126 TX Primary

Addresses

Primary practice location

1901 SW H K Dodgen Loop
Temple, TX 76502-1814

Mailing address

PO Box 844658
Dallas, TX 75284-4658

Other identifiers 7

IdentifierTypeStateIssuer
158391602MedicaidTX
158391605MedicaidTX
158391603MedicaidTX
158391604MedicaidTX
158391606MedicaidTX
158391607MedicaidTX
158391601MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vraju10422@direct.sw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20070302000077 TX Practitioner - Pediatric Medicine 7517069917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

1605 S 31St St
Baylor Scott and White Center for Dia
Temple, TX 76508-0001
Phone (254) 215-0100

2401 S 31 St
Temple, TX 76508-0001
Phone (254) 724-2459

2401 S 31St St BLDG
35 Baylor Scott and White Roney Bone and
Temple, TX 76508-0001
Phone (254) 724-2663

810 W U Ave
Temple, TX 76508-0001
Phone (254) 724-2585

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic CurrentSince Nov 11, 2009 Accepting new patients
Scott & White Clinic CurrentSince Nov 11, 2009 Accepting new patients
Scott & White Clinic Current Accepting new patients
Hillcrest Baptist Medical Center Past Accepting new patients
Scott & White Memorial Hospital Past Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients

Locations

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

1280 Arrington Rd
Ste 200
College Station, TX 77845
Phone (979) 207-6550

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

1901 SW H K Dodgen Loop
Temple, TX 76502
Phone (254) 742-9256

Organizations & group practices 6

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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1093788481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 SW H K DODGEN LOOP",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765021814",
            "telephone_number": "254-935-4000",
            "fax_number": "254-935-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJU",
        "first_name": "VENKATA",
        "middle_name": "NAKTA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "TX",
            "license": "L7126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158391602",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158391605",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158391603",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158391604",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158391606",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158391607",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158391601",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vraju10422@direct.sw.org",
            "affiliation": "N",
            "address_1": "1901 SW H K Dodgen Loop",
            "city": "Temple",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765021814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

Verify at the official NPI Registry.