Rajan Sareen MD PLLC

Primary specialty

Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X

Legal business name

RAJAN SAREEN MD PLLC

Practice address

4801 Palm Beach Blvd
Fort Myers, FL 33905-3214

Phone

(239) 694-2161

Fax

(239) 694-4131

NPI assigned

May 3, 2019

Organization subpart

No

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

Authorized official

Name

Rajan Sareen, MDNPI 1659368934

Title

Owner

Phone

(239) 694-2161

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Family Medical Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rajan Sareen, MD

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1659368934
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1556841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556841600000",
    "number": "1104481373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 PALM BEACH BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339053214",
            "telephone_number": "239-694-2161",
            "fax_number": "239-694-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 PALM BEACH BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339053214",
            "telephone_number": "239-694-2161",
            "fax_number": "239-694-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAJAN SAREEN MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-03",
        "last_updated": "2019-05-03",
        "status": "A",
        "authorized_official_last_name": "SAREEN",
        "authorized_official_first_name": "RAJAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-694-2161",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023896400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Raina Burlak PA
• Roxanne Raiola, PA-C
• Cyrus Alexander Rais, MD
• Nikhil Vijay Rajadhyaksha, M.D.
• Adikkan Oanthan Rajagopal, MD
• Krishna Priya Raju, MD
• Srinivas Raju, M.D.
• Ralph Garramone MD PA
• Sivakumar Raman, M.D.
• Archana Ramaswami, MD

• Adolescent Medicine (Internal Medicine) Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Adolescent Medicine (Internal Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.