Individual provider Active NPI

Narasimha Swamy Gollol Raju, MD

  • Gastroenterology Physician
  • Raleigh, NC
National Provider Identifier
1336344977
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
2013-01850 Issued in NC
Practice address
4420 Lake Boone TRL
Raleigh, NC 27607-7505
Phone
(919) 784-3100
NPI assigned
Jun 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 201301850 NC
Hospitalist Physician 208M00000X 018209 ME
Gastroenterology Physician 207RG0100X 2013-01850 NC Primary

Addresses

Primary practice location

4420 Lake Boone TRL
Raleigh, NC 27607-7505

Mailing address

PO Box 751069
Charlotte, NC 28275-1069

Other practice location 1

521 Moye Blvd Ste C3
Greenville, NC 27834-2849
Phone (252) 816-0800

Other practice location 2

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 816-0800

Other identifiers 3

IdentifierTypeStateIssuer
1336344977MedicaidNC
182MCOtherNCBCBS
182MCOtherNCBCBSNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nraju218507@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20131120000874 NC Practitioner - GastroenterologyPractitioner - Internal Medicine 3072669266 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Carolina MG LLCGroup PAC ID 1951828847, 723 clinicians
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

4420 Lake Boone TRL
Raleigh, NC 27607-7505
Phone (984) 215-4000

521 Moye Blvd C
Greenville, NC 27834-2849
Phone (252) 744-1440

Hospital & facility affiliations

  • Rex Hospital Hospital, Raleigh, NC, CCN 340114
  • Ecu Health Medical Center Hospital, Greenville, NC, CCN 340040

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy25
Upper gastrointestinal (GI) endoscopy for acid reflux260

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201301850NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Carolina MG, LLC Gastroenterology CurrentSince Jun 1, 2025 Accepting new patients

Locations

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

Interoperability endpoints

  • Direct secure messaging: nraju218507@direct.unc.nchie.net

Organizations & group practices 2

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 3

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": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1336344977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751069",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 LAKE BOONE TRL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077505",
            "telephone_number": "919-784-3100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "521 Moye Blvd Ste C3",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278342849",
            "country_code": "US",
            "telephone_number": "252-816-0800",
            "fax_number": "252-816-0826",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 Stantonsburg Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278342818",
            "country_code": "US",
            "telephone_number": "252-816-0800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLLOL RAJU",
        "first_name": "NARASIMHA",
        "middle_name": "SWAMY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-15",
        "last_updated": "2023-07-31",
        "certification_date": "2022-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "201301850",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "ME",
            "license": "018209",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "2013-01850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336344977",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "182MC",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "182MC",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nraju218507@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "4420 Lake Boone Trl",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276077505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.