Individual provider Active NPI

Raj Kumar Mahajan, MD

  • Obstetrics & Gynecology Physician
  • Oswego, NY
National Provider Identifier
1104869957
Registry record updated Jan 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
190331-1 Issued in NY
Practice address
42 Montcalm St
Oswego, NY 13126
Phone
(315) 343-2590
Fax
(315) 343-4197
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 190331-1 NY
Obstetrics & Gynecology Physician 207V00000X 190331-1 NY Primary

Addresses

Primary practice location

42 Montcalm St
Oswego, NY 13126

Mailing address

42 Montcalm Street
Oswego, NY 13126
Phone (315) 343-2590

Other identifiers 1

IdentifierTypeStateIssuer
0160025MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20050210000578 NY Practitioner - Obstetrics/Gynecology 1557313277 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
State University of New York at Buffalo School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

42 Montcalm St
Oswego, NY 13126-1321

42 Montcalm St
Oswego, NY 13126-1398

Hospital & facility affiliations

  • Oswego Hospital Hospital, Oswego, NY, CCN 330218

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
190331-1NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oswego County OB-GYN PC Obstetrics & Gynecology CurrentSince Nov 17, 2008 Accepting new patients
Oswego Hospital Past Accepting new patients

Locations

820 Phillips St
Fulton, NY 13069
Phone (315) 593-8393

42 Montcalm St
Oswego, NY 13126
Phone (315) 343-2590

140 W 6th St
Ste G60
Oswego, NY 13126
Phone (315) 343-2590

Interoperability endpoints

  • Direct secure messaging: rmahajan@hiemail.healtheconnections.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/HABFAA/Endpoint/HABFAA

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294963200000",
    "number": "1104869957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 MONTCALM STREET",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "13126",
            "telephone_number": "315-343-2590",
            "fax_number": "315-343-4197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 MONTCALM ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "13126",
            "telephone_number": "315-343-2590",
            "fax_number": "315-343-4197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAJAN",
        "first_name": "RAJ",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2011-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "190331-1",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "190331-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0160025",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, NY

Sources for this page

Verify at the official NPI Registry.