Penumetsa B Raju, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

18458 Issued in IA

Practice address

2750 Saint Francis Dr
Waterloo, IA 50702-5644

Phone

(319) 272-8922

Fax

(319) 272-8929

NPI assigned

Jun 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

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

Specialty

Psychiatry

Education

Other, 1963

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Covenant Medical Center IncGroup PAC ID 0244148732, 234 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercyone Waterloo Medical Center Hospital, Waterloo, IA, CCN 160067

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: praju3935609@direct.trinity-health.org

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.

• Covenant Medical Center Inc

  dba MercyOne Medical Group Northeast Iowa

  • Family Medicine Physician
  • Waterloo, IA
  • NPI 1548288160
  Medicare reassignment Care Compare group NPD
• Covenant Medical Center, Inc.

  dba MercyOne Evansdale home medical equipment

  • Customized Equipment (DME)
  • Evansdale, IA
  • NPI 1851141980
  NPD
• Floyd County Memorial Hospital Commission

  • Critical Access Hospital
  • Charles City, IA
  • NPI 1265402390
  NPD (past)
• Psychiatric Associates of Northeast Iowa PC

  • Marriage & Family Therapist
  • Waterloo, IA
  • NPI 1457428112
  NPD (past)

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

• Covenant Medical Center Inc

  dba MercyOne Waterloo Medical Center

  • General Acute Care Hospital
  • Waterloo, IA
  • NPI 1700827896
  Care Compare affiliation

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1184666539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 KIMBALL AVE",
            "address_2": "LL14",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025063",
            "telephone_number": "319-272-1590",
            "fax_number": "319-272-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 SAINT FRANCIS DR",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025644",
            "telephone_number": "319-272-8922",
            "fax_number": "319-272-8929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJU",
        "first_name": "PENUMETSA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-11",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IA",
            "license": "18458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3179598",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alayna Ragain, CNM
• Albert Rahlf, CADC
• Micaela Jean Rahm, ARNP
• Joanna Rahnavardi, MAE, LMHC
• Ajay Rajagopalan, MD
• Krista Ralston
• Pradeep Manjanbail Ramesh, MD
• Russell Joseph Randall
• Tanya J Rapien, ARNP
• Rasmussen Counseling and Spiritual Direction Inc

• Psychiatry Physician in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Psychiatry Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.