Raja Dutta, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A115189 Issued in CA

Practice address

3627 Lakeland Way
Elk Grove, CA 95758-4645

Phone

(530) 902-4766

Fax

(916) 236-3398

NPI assigned

Mar 2, 2011

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 CA

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

Specialty

Psychiatry

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cep America - Psychiatry PCGroup PAC ID 0244522159, 93 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy San Juan Medical Center Hospital, Carmichael, CA, CCN 050516

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Cep America - Psychiatry PC

  • Psychiatry Physician
  • Santa Maria, CA
  • NPI 1538757232
  Medicare reassignment Care Compare group NPD
• Department of State Hospitals

  • Psychiatric Hospital
  • Coalinga, CA
  • NPI 1124078704
  Medicare reassignment NPD
• County of Monterey

  • Adult Mental Health Clinic/Center
  • Salinas, CA
  • NPI 1467584805
  Medicare reassignment
• Cep America - Psychiatry PC

  • Psychiatry Physician
  • Indio, CA
  • NPI 1144195926
  NPD
• Cep America - Psychiatry, PC

  • Psychiatry Physician
  • Woodland, CA
  • NPI 1386158491
  NPD
• County of Monterey Behavioral Health

  • Clinical Child & Adolescent Psychologist
  • Salinas, CA
  • NPI 1073645586
  NPD
• Department of State Hospitals

  • Psychiatric Hospital
  • Atascadero, CA
  • NPI 1174573802
  NPD
• Department of State Hospitals

  • Psychiatric Hospital
  • Napa, CA
  • NPI 1326098161
  NPD
• Mark David Levine, MD, Psychiatry Associates, P.C.

  • Psychiatry Physician
  • Sacramento, CA
  • NPI 1346483682
  NPD (past)

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

• Dignity Health

  • General Acute Care Hospital
  • Carmichael, CA
  • NPI 1972541498
  Care Compare affiliation

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

{
    "created_epoch": "1299024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376265600000",
    "number": "1285932137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3627 LAKELAND WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957584645",
            "telephone_number": "530-902-4766",
            "fax_number": "916-236-3398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3627 LAKELAND WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957584645",
            "telephone_number": "530-902-4766",
            "fax_number": "916-236-3398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTTA",
        "first_name": "RAJA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-02",
        "last_updated": "2013-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A115189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenavy Duong
• Leticia Duran
• Hailey Durant
• Adrianna Durrell
• Macie Dutra, MA
• Dominique Duverney, FNP
• Shannon Rose Dwyer
• E&S Jensen Inc.
• Erika Easter- Phea
• Japera Easterling Clavo

• Psychiatry Physician in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2013; 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.