Active NPI
Neeraj Kumar Raghunath, MD
- Pediatric Gastroenterology Physician
- Hollywood, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Gastroenterology Physician
- License
- ME106643
- Practice address
- 1150 N 35TH Ave
Suite 545
Hollywood, FL 33021-5424 - Phone
- (954) 967-9400
- NPI assigned
- Mar 1, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Gastroenterology Physician | 2080P0206X | 247500 | NY | |
| Pediatric Gastroenterology Physician | 2080P0206X | ME106643 | FL | Primary |
Addresses
Primary practice location
1150 N 35TH Ave
Suite 545
Hollywood, FL 33021-5424
Mailing address
5955 Ponce de Leon Blvd.
Coral Gables, FL 33146
Phone (305) 661-1515
Other practice location 1
7100 W 20th Ave Ste 616
Hialeah, FL 33016-1814
Phone (305) 556-4263
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002484900 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
975 Baptist Way
Homestead, FL 33033-7600
Phone 3056611515243
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME106643 | FL | MD | Pediatric Gastroenterology Physician |
| 247500 | NY | MD | Pediatric Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kidz Medical Services, Inc | Pediatric Gastroenterology | Current | Accepting new patients |
| Kidz Medical Services, Inc | Current | Accepting new patients | |
| Kidz Medical Services, Inc. | Pediatric Gastroenterology | Past | Accepting new patients |
Locations
9980 Central Park Blvd N
Ste 318
Boca Raton, FL 33428
Phone (561) 451-0500
5955 Ponce de Leon Blvd
Coral Gables, FL 33146
Phone (305) 662-8668
7100 W 20th Ave
Ste 616
Hialeah, FL 33016
Phone (305) 435-4465
1150 N 35th Ave
Ste 545
Hollywood, FL 33021
Phone (954) 966-6225
3800 Johnson St
Ste J
Hollywood, FL 33021
Phone (954) 967-9400
975 Baptist Way
Ste 203
Homestead, FL 33033
Phone (305) 242-8200
Interoperability endpoints
- neerajraghunath@kms.allscriptsdirect.net
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.
-
- Children's Hospital
- Coral Gables, FL
- NPI 1366408379
Pediatric Gastroenterology
-
- Pediatric Nephrology Physician
- South Miami, FL
- NPI 1730637927
-
- Pediatric Gastroenterology Physician
- Hollywood, FL
- NPI 1306191580
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570060800000",
"number": "1275855595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5955 PONCE DE LEON BLVD.",
"city": "CORAL GABLES",
"state": "FL",
"postal_code": "33146",
"telephone_number": "305-661-1515",
"fax_number": "305-662-3723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1150 N 35TH AVE",
"address_2": "SUITE 545",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330215424",
"telephone_number": "954-967-9400"
}
],
"practiceLocations": [
{
"address_1": "7100 W 20th Ave Ste 616",
"address_purpose": "LOCATION",
"city": "Hialeah",
"state": "FL",
"postal_code": "330161814",
"country_code": "US",
"telephone_number": "305-556-4263",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RAGHUNATH",
"first_name": "NEERAJ",
"middle_name": "KUMAR",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-03-01",
"last_updated": "2019-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "NY",
"license": "247500",
"primary": false
},
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "FL",
"license": "ME106643",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "002484900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hollywood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; 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.