Organization Active NPI

Biby Rajan-George M.D PLLC

Doing business as Biby Rajan-George

  • Internal Medicine Physician
  • Fayetteville, NY
National Provider Identifier
1124790324
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BIBY RAJAN-GEORGE M.D PLLC
Doing business as
Biby Rajan-George
Practice address
4000 Medical Center Drive
Fayetteville, NY 13066
Phone
(315) 637-2665
NPI assigned
Oct 5, 2021
Last updated
Oct 5, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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

Authorized official

Name
Dr. Biby Elizabeth Rajan-George, MDNPI 1205824976
Title
Physician
Phone
(315) 637-2665

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

4000 Medical Center Drive
Fayetteville, NY 13066

Mailing address

4000 Medical Center Drive
Suite # 403
Fayetteville, NY 13066
Phone (315) 637-2665

Other names 1

  • Biby Rajan-George Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211216000551 NY Part B Supplier - Clinic/Group Practice 7517358195 Receives reassigned benefits from 4 practitioners
Practice locations: Fayetteville, NY

National Provider Directory

National Provider Directory

Locations

4000 Medical Center Dr
Fayetteville, NY 13066
Phone (315) 637-2665

4000 Medical Center Dr
Ste 403
Fayetteville, NY 13066
Phone (315) 329-4975

5793 Widewaters Pkwy
Ste 203
Syracuse, NY 13214

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1633392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633392000000",
    "number": "1124790324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 MEDICAL CENTER DRIVE",
            "address_2": "SUITE # 403",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "13066",
            "telephone_number": "315-637-2665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 MEDICAL CENTER DRIVE",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "13066",
            "telephone_number": "315-637-2665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIBY RAJAN-GEORGE M.D PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-05",
        "last_updated": "2021-10-05",
        "certification_date": "2021-09-21",
        "status": "A",
        "authorized_official_last_name": "RAJAN-GEORGE",
        "authorized_official_first_name": "BIBY",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "315-637-2665",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Biby Rajan-George",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayetteville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.