Individual provider Active NPI

Raj K Nangunoori, M.D.

  • Neurological Surgery Physician
  • Monroeville, PA
National Provider Identifier
1134477037
Registry record updated Oct 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
MD452631 Issued in PA
Practice address
2580 Haymaker Rd Ste 106
Monroeville, PA 15146-3500
Phone
(412) 858-7766
Fax
(412) 858-7769
NPI assigned
Aug 27, 2012
Last updated
Oct 2, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X MD452631 PA Primary

Addresses

Primary practice location

2580 Haymaker Rd Ste 106
Monroeville, PA 15146-3500

Mailing address

2580 Haymaker Rd Ste 106
Monroeville, PA 15146-3500
Phone (412) 858-7766

Other identifiers 2

IdentifierTypeStateIssuer
14492843OtherCAQH
103238391MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rnangunoori26102@direct.ahn.org

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
I20230419001948 TX Practitioner - Neurosurgery 1456639707 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Seton Family of Doctors CurrentSince Mar 1, 2023 Accepting new patients
Seton Family of Doctors Neurological Surgery CurrentSince Mar 1, 2023 Accepting new patients

Locations

1400 N Interstate 35
Ste 300
Austin, TX 78701
Phone (512) 324-8300

5103 Kyle Center Dr
Ste 104
Kyle, TX 78640
Phone (512) 268-2929

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

Interoperability endpoints

  • Direct secure messaging: rnangunoori1056688@directc.mercy.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1134477037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2580 HAYMAKER RD STE 106",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151463500",
            "telephone_number": "412-858-7766",
            "fax_number": "412-858-7769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 HAYMAKER RD STE 106",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151463500",
            "telephone_number": "412-858-7766",
            "fax_number": "412-858-7769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANGUNOORI",
        "first_name": "RAJ",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-27",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "PA",
            "license": "MD452631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14492843",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103238391",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rnangunoori26102@direct.ahn.org",
            "affiliation": "N",
            "address_1": "2580 Haymaker Rd Ste 106",
            "city": "Monroeville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "151463500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monroeville, PA

Sources for this page

Verify at the official NPI Registry.