Paul J. Raiman, M.D.

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

01034793A Issued in IN

Practice address

11141 Parkview Plaza Dr
Suite 310
Fort Wayne, IN 46845-1701

Phone

(260) 489-8898

Fax

(260) 373-4695

NPI assigned

Aug 16, 2005

Last updated

Mar 23, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northeast Indiana Colon Rectal Surgeons PC

  • Colon & Rectal Surgery Physician
  • Fort Wayne, IN
  • NPI 1912998014
  NPD (past) Authorized official
• Northeast Indiana Colon Rectal Surgeons, P.C.

  • Colon & Rectal Surgery Physician
  • Fort Wayne, IN
  • NPI 1255322244
  Authorized official Same address or phone

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363996800000",
    "number": "1114919131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 E DUPONT RD",
            "address_2": "SUITE 1",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251545",
            "telephone_number": "260-373-9700",
            "fax_number": "260-373-9740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11141 PARKVIEW PLAZA DR",
            "address_2": "SUITE 310",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701",
            "telephone_number": "260-489-8898",
            "fax_number": "260-373-4695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAIMAN",
        "first_name": "PAUL",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2013-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "IN",
            "license": "01034793A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000595629",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100096150A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "020037713",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0610888",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000614766",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100096150",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin A Rahn, M.D.
• Kristin E. Rahn
• Shannon Rahn, MSED
• Gerald J. Rahrig, DDS
• Pradip Rai
• Desiree Raines, RBT
• Jeanne Kay Raines, MS (MHC), NCC, LMHC
• Marcus Ervin Raines, M.D.
• Naomi C. Rainwater, MS, LMFT
• Raj Clinics Professional Services Corporation

• Colon & Rectal Surgery Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Colon & Rectal Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.