NPIMap

Individual provider Active NPI

Rajesh Makkenchery, MD

  • Surgery Physician
  • Gettysburg, PA
National Provider Identifier
1104885748
Registry record updated Jul 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD428731 Issued in PA
Practice address
450 S Washington St
3Rd Floor, Suite C
Gettysburg, PA 17325-2500
Phone
(717) 334-8141
Fax
(717) 334-1885
NPI assigned
Mar 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2016

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD428731 PA Primary
Pediatric Surgery Physician 2086S0120X MD428731 PA
Trauma Surgery Physician 2086S0127X MD428731 PA
Surgical Oncology Physician 2086X0206X MD428731 PA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD428731 PA

Addresses

Primary practice location

450 S Washington St
3Rd Floor, Suite C
Gettysburg, PA 17325-2500

Mailing address

4 Brigadier Court
Gettysburg, PA 17325
Phone (508) 612-8485

Other identifiers 8

IdentifierTypeStateIssuer
1840510OtherPAHIGHMARK BLUE SHIELD
20072213OtherPAAMERIHEALTH MERCY-WMG
7842893OtherPAAETNA
211140OtherPAJOHNS HOPKINS
50075821OtherPACAPITAL BLUE CROSS WMG
101565162MedicaidPA
1551336OtherPAGATEWAY-WMG
232743OtherPAUNISON WMG

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20060511000254 PA Practitioner - General Surgery 3577574011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

450 S Washington St 3Rd FL C
Gettysburg Surgical Assoc
Gettysburg, PA 17325-2500
Phone (717) 339-3110

Hospital & facility affiliations

  • Gettysburg Hospital Hospital, Gettysburg, PA, CCN 390065
  • Wellspan York Hospital Hospital, York, PA, CCN 390046
  • Wellspan Waynesboro Hospital Hospital, Waynesboro, PA, CCN 390138

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy55
Hernia repair (minimally invasive)32
Upper gastrointestinal (GI) endoscopy for acid reflux26
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD428731PAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group Pediatric Surgery CurrentSince Mar 31, 2008 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Wellspan Medical Group CurrentSince Mar 31, 2008 Accepting new patients
The Gettysburg Hospital Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

450 S Washington St
Ste C
Gettysburg, PA 17325
Phone (717) 334-8141

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

1600 S George St
York, PA 17403
Phone (717) 848-3615

Interoperability endpoints

  • Direct secure messaging: rmakkenchery13867@wellspan.direct-ci.com

Organizations & group practices 5

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 9

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": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1104885748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 BRIGADIER COURT",
            "city": "GETTYSBURG",
            "state": "PA",
            "postal_code": "17325",
            "telephone_number": "508-612-8485",
            "fax_number": "717-334-1885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 S WASHINGTON ST",
            "address_2": "3RD FLOOR, SUITE C",
            "city": "GETTYSBURG",
            "state": "PA",
            "postal_code": "173252500",
            "telephone_number": "717-334-8141",
            "fax_number": "717-334-1885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKKENCHERY",
        "first_name": "RAJESH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD428731",
            "primary": true
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "PA",
            "license": "MD428731",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "PA",
            "license": "MD428731",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "PA",
            "license": "MD428731",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "PA",
            "license": "MD428731",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1840510",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY-WMG",
            "identifier": "20072213",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7842893",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHNS HOPKINS",
            "identifier": "211140",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS WMG",
            "identifier": "50075821",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101565162",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY-WMG",
            "identifier": "1551336",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON WMG",
            "identifier": "232743",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gettysburg, PA

Sources for this page

Verify at the official NPI Registry.