Individual provider Active NPI

Vijayalakshmi Raghu, M.D.

  • Family Medicine Physician
  • Irving, TX
National Provider Identifier
1225220940
Registry record updated Jan 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
N8561 Issued in TX
Practice address
3365 Regent Blvd
Suite 110
Irving, TX 75063-3122
Phone
(972) 905-3917
Fax
(940) 205-4525
NPI assigned
Aug 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2007-01163 NC
Family Medicine Physician 207Q00000X N8561 TX Primary

Addresses

Primary practice location

3365 Regent Blvd
Suite 110
Irving, TX 75063-3122

Mailing address

3365 Regent Blvd
Ste 110
Irving, TX 75063-3125
Phone (972) 905-3917

Other identifiers 2

IdentifierTypeStateIssuer
N8561OtherTXMEDICAL LICENSE
340614YKY6OtherTXMEDICARE NUMBER

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20111216000357 TX Practitioner - Family Practice 2961575352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3365 Regent Blvd
Suite 110
Irving, TX 75063-3125
Phone (469) 713-3838

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2007-01163NCMDFamily Medicine Physician
N8561TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Irving Coppell Primary Care Doctors PLLC Family Medicine CurrentSince Oct 1, 2015 Accepting new patients
Primamed Physicians PLLC PastSince Feb 9, 2025 Accepting new patients
Primamed Physicians PLLC Past Accepting new patients

Locations

3365 Regent Blvd
Ste 110
Irving, TX 75063
Phone (469) 713-3838

Interoperability endpoints

  • Direct secure messaging: vijayalakshmi.raghu.1@11475.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/11475/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483488000000",
    "number": "1225220940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3365 REGENT BLVD",
            "address_2": "STE 110",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750633125",
            "telephone_number": "972-905-3917",
            "fax_number": "940-205-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3365 REGENT BLVD",
            "address_2": "SUITE 110",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750633122",
            "telephone_number": "972-905-3917",
            "fax_number": "940-205-4525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGHU",
        "first_name": "VIJAYALAKSHMI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-16",
        "last_updated": "2017-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2007-01163",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N8561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "N8561",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER",
            "identifier": "340614YKY6",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.