Pavankumar Raja, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

27793 Issued in MD

Practice address

3165 Crain Hwy Ste 100
Waldorf, MD 20603-4847

Phone

(301) 885-2500

NPI assigned

Nov 15, 2019

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 MD, DC2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Loma Linda University School of Medicine, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Sage Physical Therapy & Wellness LLC

  • Physical Therapy Clinic/Center
  • Cambridge, MD
  • NPI 1467757575

  DC, Physical Therapist

  Medicare reassignment NPD
• Active Physical Therapy Services, LLC

  • Physical Therapist
  • Laurel, MD
  • NPI 1225217334
  NPD (past)
• Sports Physical Therapy of Towson, P.a.

  • Physical Therapist
  • Towson, MD
  • NPI 1770650392
  NPD (past)

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

{
    "created_epoch": "1573776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573776000000",
    "number": "1326683186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419666",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022419666",
            "telephone_number": "410-970-8190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3165 CRAIN HWY STE 100",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034847",
            "telephone_number": "301-885-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJA",
        "first_name": "PAVANKUMAR",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-15",
        "last_updated": "2019-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "27793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• R.E.a.M LLC
• Rachels Hair Loft LLC
• Radical Life Changes LLC
• Rahnys Safemind Place
• Serenity Rain, LCSW, LICSW, LCSW-C
• Ram Recovery LLC
• Ram Recovery LLC
• Venkat Sundaram Ramanan, M.D.
• Olivia Rampersaud, DDS
• Ramsey Counseling and Consulting, LLC

• Physical Therapist in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.