Individual provider Active NPI

Shine Kochukunju Raju, M.B.B.S.

  • Student in an Organized Health Care Education/Training Program
  • Farmington, CT
National Provider Identifier
1326326968
Registry record updated Apr 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
Uconn Health Ctr
263 Farmington Ave
Farmington, CT 06030-0001
Phone
(516) 943-2400
NPI assigned
Aug 1, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

Uconn Health Ctr
263 Farmington Ave
Farmington, CT 06030-0001

Mailing address

83 Leafwood LN
Apt 220
Groton, CT 06340-6250
Phone (516) 943-2400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20180914002779 OH Practitioner - Pulmonary Disease 9133470057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians

Practice addresses (Care Compare)

1000 Auburn Dr
Beachwood, OH 44122-4317
Phone (216) 285-5028

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.19 of 100Reported as group
Quality
63.13
Promoting interoperability
100
Improvement activities
40
Cost
74.18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospitals Medical Group Inc CurrentSince Jan 14, 2019 Accepting new patients

Locations

1000 Auburn Dr
Beachwood, OH 44122
Phone (216) 285-4125

1000 Auburn Dr
Ste 200
Beachwood, OH 44122
Phone (216) 285-5133

8055 Mayfield Rd
Ste 105
Chesterland, OH 44026
Phone (440) 214-8024

11100 Euclid Ave
Cleveland Heights, OH 44106

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

Interoperability endpoints

  • Direct secure messaging: shinekochukun.raju@uhhs.allscriptsdirect.net
  • Direct secure messaging: skochukunjuraju36058@ehrdirect.uhhospitals.org

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.

Hospital & facility affiliations 5

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": "1312156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396310400000",
    "number": "1326326968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 LEAFWOOD LN",
            "address_2": "APT 220",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063406250",
            "telephone_number": "516-943-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UCONN HEALTH CTR",
            "address_2": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060300001",
            "telephone_number": "516-943-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCHUKUNJU RAJU",
        "first_name": "SHINE",
        "name_prefix": "Dr.",
        "credential": "M.B.B.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-01",
        "last_updated": "2014-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.