Kishan Raja, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

18999 Issued in AZ

Practice address

4801 S Lakeshore Dr Ste 204
Tempe, AZ 85282-7157

Phone

(480) 256-9299

Fax

(480) 422-2474

NPI assigned

May 11, 2022

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

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Recovia LLCGroup PAC ID 1456629211, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Recovia LLC

  • Specialist
  • Phoenix, AZ
  • NPI 1427421098
  Medicare reassignment Care Compare group NPD
• Phoenix Health and Wellbeing LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tempe, AZ
  • NPI 1619639556

  Clinical

  NPD

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

{
    "created_epoch": "1652227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1265178248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 S LAKESHORE DR STE 204",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827157",
            "telephone_number": "480-256-9299",
            "fax_number": "480-422-2474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 S LAKESHORE DR STE 204",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827157",
            "telephone_number": "480-256-9299",
            "fax_number": "480-422-2474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJA",
        "first_name": "KISHAN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-11",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "18999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah R Radtke, M.S., CCC-SLP
• Manda Maria Radulovic
• Sanam Rahbar, OTR
• Anup Rai, M.D.
• William B Rainey, OD
• Rajiv Parikh MD PC
• Julie Ann Rake, PA-C
• Mikki Rakestrow
• Raley'S Arizona LLC
• Katie Beutler Ralon, PA-C

• Clinical Social Worker in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; 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.