NPIMap

Individual provider Active NPI

Sabrina Shaheen Raja, P.A.-C

  • Physician Assistant
  • Greenville, SC
National Provider Identifier
1164456083
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1354 Issued in SC
Practice address
125 Halton Rd Ste 200
Greenville, SC 29607-3507
Phone
(864) 232-7338
NPI assigned
Jul 10, 2006
Last updated
May 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 103691 NC
Physician Assistant 363A00000X 1354 SC Primary

Addresses

Primary practice location

125 Halton Rd Ste 200
Greenville, SC 29607-3507

Mailing address

PO Box 8676
Greenville, SC 29604-8676
Phone (864) 232-7338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081110000179 SC Practitioner - Physician Assistant 0648339465 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical University of South Carolina College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastroenterology Associates, PAGroup PAC ID 1951215433, 57 clinicians

Practice addresses (Care Compare)

112 A Hospital Dr
Simpsonville, SC 29681-3226
Phone (864) 232-7338

125 Halton Rd
Suite 200
Greenville, SC 29607-3507
Phone (864) 232-7338

3424 Augusta Rd
Suite 200
Greenville, SC 29605-2150
Phone (864) 232-7338

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1354SCMDGeneral Practice Dentistry
103691NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jan 1, 2010 Accepting new patients
Prisma Health University Medical Group CurrentSince Jan 1, 2010 Accepting new patients
Gastroenterology Associates, PA CurrentSince Oct 1, 2008 Accepting new patients
Gastroenterology Associates, PA CurrentSince Oct 1, 2008 Accepting new patients
Carolina Digestive Health Associates, PA PastSince Oct 29, 2023 Accepting new patients
Greenville Health System Past Accepting new patients

Locations

105 Chapman Hill Rd
#A
Clemson, SC 29631

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

200 Fleetwood Dr
Easley, SC 29640
Phone (864) 442-7200

125 Halton Rd
Ste 200
Greenville, SC 29607

200 Patewood Dr
Ste B200
Greenville, SC 29615
Phone (864) 454-2226

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

317 Saint Francis Dr
Ste 170
Greenville, SC 29601
Phone (864) 255-1886

3424 Augusta Rd
Ste 200
Greenville, SC 29605

112A Hospital Dr
Simpsonville, SC 29681

112B Hospital Dr
Simpsonville, SC 29681
Phone (864) 454-6850

Organizations & group practices 7

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.

Hospital & facility affiliations 55

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 55

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1164456083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8676",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296048676",
            "telephone_number": "864-232-7338",
            "fax_number": "864-239-6645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 HALTON RD STE 200",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073507",
            "telephone_number": "864-232-7338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJA",
        "first_name": "SABRINA",
        "middle_name": "SHAHEEN",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103691",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "1354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.