Organization Active NPI

DRS. Raja & Raja, PA

  • Specialist
  • Englewood, FL
National Provider Identifier
1174810642
Registry record updated Jul 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
DRS. RAJA & RAJA, PA
Practice address
900 Pine St
Suite 215
Englewood, FL 34223-4418
Phone
(941) 475-5672
Fax
(941) 473-1456
NPI assigned
Jul 6, 2011
Last updated
Jul 6, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2011

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

Authorized official

Name
Premala Raja, M.D.NPI 1194736504
Title
Owner
Phone
(941) 475-5672

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
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

900 Pine St
Suite 215
Englewood, FL 34223-4418

Mailing address

900 Pine St
Suite 215
Englewood, FL 34223-4418
Phone (941) 475-5672

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120201000345 FL Part B Supplier - Clinic/Group Practice 7113184219 Receives reassigned benefits from 2 practitioners
Practice locations: Venice, FL; Englewood, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0988050DRS Raja & Raja PA900 E Pine St # 215, Englewood, FL 34223Certificate of waiverJun 18, 2027

National Provider Directory

National Provider Directory

Locations

900 Pine St
Ste 215218
Englewood, FL 34223

1900 S Tamiami Trl
Venice, FL 34293
Phone (941) 475-5672

1990 S Tamiami Trl
Venice, FL 34293
Phone (941) 408-7188

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309910400000",
    "number": "1174810642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 PINE ST",
            "address_2": "SUITE 215",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342234418",
            "telephone_number": "941-475-5672",
            "fax_number": "941-473-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 PINE ST",
            "address_2": "SUITE 215",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342234418",
            "telephone_number": "941-475-5672",
            "fax_number": "941-473-1456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS. RAJA & RAJA, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-06",
        "last_updated": "2011-07-06",
        "status": "A",
        "authorized_official_last_name": "RAJA",
        "authorized_official_first_name": "PREMALA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-475-5672",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.