Judah Rajendran Ravi Raja Malar Vannan, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

350 W Thomas Rd
Phoenix, AZ 85013-4409

Phone

(216) 338-5003

NPI assigned

Apr 11, 2025

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 names 1

• Dr. Judah Rajendran Other name

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1744329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1194510016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CREIGHTON UNIVERSITY",
            "address_2": "3100 N. CENTRAL AVENUE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85012",
            "telephone_number": "216-338-5003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134409",
            "telephone_number": "216-338-5003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVI RAJA MALAR VANNAN",
        "first_name": "JUDAH RAJENDRAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-11",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUDAH",
            "last_name": "RAJENDRAN",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• John Frederick Rausch Jr., M.D.
• Kayla Grace Rausch, FNP
• Nicole J Rauscher, ACNP
• Kavi Raval, D.O
• Amanda Raver, COTA/L
• Jyotsna Ravi, MD
• Lalitha Ravi, M.D.
• Rajagopalan Ravi, MD
• Srekar Nagisetty Ravi, MD
• Vaishali Ravikumar, MD

• Student in an Organized Health Care Education/Training Program in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Student in an Organized Health Care Education/Training Program in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.