Individual provider Active NPI

Rajasekhar Nalluri, M.D.

  • Plastic Surgery Physician
  • La Jolla, CA
National Provider Identifier
1245254838
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
C153635 Issued in CA
Practice address
7300 Girard Ave Ste 211
La Jolla, CA 92037-5138
Phone
(858) 299-8999
Fax
(858) 225-1855
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X ME84444 FL
Plastic Surgery Physician 208200000X C153635 CA Primary

Addresses

Primary practice location

7300 Girard Ave Ste 211
La Jolla, CA 92037-5138

Mailing address

258 Coast Blvd
La Jolla, CA 92037-4609
Phone (858) 299-8999

Other practice location 1

9415 Nall Ave Ste 201
Prairie Village, KS 66207-2529
Phone (913) 600-2958

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20191212002170 IL Practitioner - Plastic and Reconstructive Surgery 0840203212 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C153635CAMDPlastic Surgery Physician
ME84444FLMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Health Physicians CurrentSince Nov 21, 2019 Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

2400 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-6310

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1245254838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 COAST BLVD",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920374609",
            "telephone_number": "858-299-8999",
            "fax_number": "858-225-1855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 GIRARD AVE STE 211",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920375138",
            "telephone_number": "858-299-8999",
            "fax_number": "858-225-1855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9415 Nall Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Prairie Village",
            "state": "KS",
            "postal_code": "662072529",
            "country_code": "US",
            "telephone_number": "913-600-2958",
            "fax_number": "913-270-6982",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NALLURI",
        "first_name": "RAJASEKHAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME84444",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "C153635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.