Individual provider Active NPI

Rajagopalan Ravi, MD

  • Surgery Physician
  • Phoenix, AZ
National Provider Identifier
1215938147
Registry record updated Sep 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
10584 Issued in AZ
Practice address
2632 N 20TH St
Phoenix, AZ 85006-1339
Phone
(602) 266-2200
Fax
(602) 240-5862
NPI assigned
Aug 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 10584 AZ Primary
Vascular Surgery Physician 2086S0129X 10584 AZ

Addresses

Primary practice location

2632 N 20TH St
Phoenix, AZ 85006-1339

Mailing address

PO Box 61773
Phoenix, AZ 85082-1773
Phone (602) 266-2200

Other identifiers 3

IdentifierTypeStateIssuer
220004MedicaidAZ
WCSKQOtherAZSUN HEALTH GROUP #
020046638OtherAZRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ahi Cardiovascular Surgeons LTD Surgery Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347408000000",
    "number": "1215938147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 61773",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850821773",
            "telephone_number": "602-266-2200",
            "fax_number": "602-240-6177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2632 N 20TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850061339",
            "telephone_number": "602-266-2200",
            "fax_number": "602-240-5862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVI",
        "first_name": "RAJAGOPALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2012-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "10584",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "AZ",
            "license": "10584",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220004",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUN HEALTH GROUP #",
            "identifier": "WCSKQ",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "020046638",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.