Individual provider Active NPI

Priyanka Ajaysinh Rajput, MD

  • Family Medicine Physician
  • Stockton, CA
National Provider Identifier
1114691870
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
195194 Issued in CA
Practice address
701 E Channel St
Stockton, CA 95202-2628
Phone
(209) 944-4700
NPI assigned
Aug 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 5101021786 MI
Family Medicine Physician 207Q00000X 195194 CA Primary

Addresses

Primary practice location

701 E Channel St
Stockton, CA 95202-2628

Mailing address

701 E Channel St
Stockton, CA 95202-2628
Phone (209) 944-4700

Other practice location 1

1000 Oakland Dr
Kalamazoo, MI 49008-1282
Phone (269) 337-4600

Other practice location 2

300 North Ave
Battle Creek, MI 49017-3307
Phone (269) 965-8866

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20241118000311 CA Practitioner - Family Practice 9133523384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Centers, Inc.Group PAC ID 8426968520, 47 clinicians

Practice addresses (Care Compare)

701 E Channel St
Stockton, CA 95202-2628
Phone (209) 944-4700

747 E Channel St
Stockton, CA 95202-2628
Phone (209) 940-4670

Hospital & facility affiliations

  • St Joseph'S Medical Center of Stockton Hospital, Stockton, CA, CCN 050084

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
195194CAMDFamily Medicine Physician
5101021786MIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Centers, Inc. Current Accepting new patients
Community Medical Centers Inc CurrentSince Oct 28, 2024 Accepting new patients
Community Medical Centers, Inc. CurrentSince Oct 28, 2024 Accepting new patients

Locations

701 E Channel St
Stockton, CA 95202
Phone (209) 944-4700

7210 Murray Dr
Stockton, CA 95210
Phone (209) 373-2816

730 N Central Ave
Tracy, CA 95376
Phone (209) 820-1500

Interoperability endpoints

  • Direct secure messaging: prajput768547@direct.ochin.org
  • Direct secure messaging: priyanka.rajput.p1@direct.gracehealthmi.nextgenshare.com
  • Direct secure messaging: priyanka.rajput.p1@direct.cmcentersinc.nextgenshare.com

Organizations & group practices 3

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": "1628121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1114691870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E CHANNEL ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952022628",
            "telephone_number": "209-944-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E CHANNEL ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952022628",
            "telephone_number": "209-944-4700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Oakland Dr",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490081282",
            "country_code": "US",
            "telephone_number": "269-337-4600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 North Ave",
            "address_purpose": "LOCATION",
            "city": "Battle Creek",
            "state": "MI",
            "postal_code": "490173307",
            "country_code": "US",
            "telephone_number": "269-965-8866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAJPUT",
        "first_name": "PRIYANKA",
        "middle_name": "AJAYSINH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-05",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "5101021786",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "195194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.