Rajan Santhamoorthy, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

2020035854 Issued in MO

Practice address

13013 Fuller Ave Ste a
Grandview, MO 64030-2687

Phone

(816) 214-5548

NPI assigned

Jul 4, 2021

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• The Medina Clinic, Incorporated

  • Primary Care Clinic/Center
  • Grandview, MO
  • NPI 1073893046
  NPD (past)

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

{
    "created_epoch": "1625356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625356800000",
    "number": "1336710060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 HORIZON CT",
            "city": "BELLE ISLE",
            "state": "FL",
            "postal_code": "328096187",
            "telephone_number": "781-454-5427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13013 FULLER AVE STE A",
            "city": "GRANDVIEW",
            "state": "MO",
            "postal_code": "640302687",
            "telephone_number": "816-214-5548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTHAMOORTHY",
        "first_name": "RAJAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-04",
        "last_updated": "2021-07-04",
        "certification_date": "2021-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MO",
            "license": "2020035854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Christine Ryan, MS
• Sabr Living LLC
• Salima Transportation LLC
• Salyr Prescription Inc.
• Sam'S Club Optical
• Alexandra Scavuzzo, D.C.
• Kristy Anne Schieszer, M.S., CCC-A
• Jill M Schlottach, OTR L
• Hannah Schoenau, C-SLPA
• Rachel S Schwepler, CPM

• All providers in Grandview, MO
• General Practice Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.