Individual provider Active NPI

Raja Naidu, MD

  • Cardiovascular Disease Physician
  • Odessa, TX
National Provider Identifier
1124095161
Registry record updated Sep 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
K1267 Issued in TX
Practice address
605 E 4TH St
Suite 203
Odessa, TX 79761-5100
Phone
(432) 617-8329
Fax
(432) 339-8454
NPI assigned
Mar 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X K1267 TX Primary

Addresses

Primary practice location

605 E 4TH St
Suite 203
Odessa, TX 79761-5100

Mailing address

605 E 4TH St
Suite 203
Odessa, TX 79761-5100
Phone (432) 617-8329

Other identifiers 1

IdentifierTypeStateIssuer
151043001MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20090219000279 TX Practitioner - Cardiovascular Disease (Cardiology) 0648180141 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Texas Southwestern Medical School at Dallas, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Big Bend Medical GroupGroup PAC ID 2163326281, 46 clinicians

Practice addresses (Care Compare)

1608 W FM
Big Spring, TX 79720-4113

1608 W FM 700
Big Spring, TX 79720-4113

4911 Andrews Hwy
Midland, TX 79703-4507

500 W 4TH St
Odessa, TX 79761-5001
Phone (432) 640-4380

520 E 6TH St
Odessa, TX 79761-4527
Phone (432) 582-8535

605 E 4TH St
Odessa, TX 79761-5100

Hospital & facility affiliations

  • Odessa Regional Medical Center Hospital, Odessa, TX, CCN 450661
  • Midland Memorial Hospital Hospital, Midland, TX, CCN 450133
  • Medical Center Hospital Hospital, Odessa, TX, CCN 450132
  • Winkler County Memorial Hospital Hospital, Kermit, TX, CCN 451314
  • Ward Memorial Hospital Hospital, Monahans, TX, CCN 451373

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting45
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K1267TXMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Big Bend Medical Group CurrentSince Oct 16, 2024 Accepting new patients
Big Bend Medical Group CurrentSince Oct 16, 2024 Accepting new patients
Odessa Regional Hospital LP Past Accepting new patients

Locations

1608 W FM 700
Ste C
Big Spring, TX 79720
Phone (432) 263-7700

4911 Andrews Hwy
Ste B
Midland, TX 79703
Phone (432) 620-8669

4911 Andrews Hwy
Ste A
Midland, TX 79703
Phone (432) 689-0210

400 S Ike Ave
Monahans, TX 79756
Phone (432) 617-8329

605 E 4th St
Ste 203
Odessa, TX 79761
Phone (432) 614-6950

605 E 4th St
Ste 300
Odessa, TX 79761
Phone (432) 337-4347

500 W 4th St
Odessa, TX 79761
Phone (432) 640-1000

520 E 6th St
Odessa, TX 79761
Phone (432) 332-0929

420 E 6th St
Ste 206
Odessa, TX 79761
Phone (432) 582-8480

7101 Eastridge Rd
Odessa, TX 79765
Phone (432) 550-0048

Interoperability endpoints

  • Direct secure messaging: raja.naidu.1@1603.direct.athenahealth.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 7

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316131200000",
    "number": "1124095161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 E 4TH ST",
            "address_2": "SUITE 203",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615100",
            "telephone_number": "432-617-8329",
            "fax_number": "432-339-8454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 E 4TH ST",
            "address_2": "SUITE 203",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615100",
            "telephone_number": "432-617-8329",
            "fax_number": "432-339-8454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIDU",
        "first_name": "RAJA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2011-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "K1267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151043001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.