Raz Dilip Penmatcha, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

202259 Issued in NC

Practice address

1310 24TH Ave S
Nashville, TN 37212

Phone

(615) 875-6000

NPI assigned

Apr 26, 2006

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: raz.penmatcha.p2@direct.urologyqc.nextgenshare.com

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.

• Eye Surgeons Associates PC

  • Eyewear Supplier
  • Rock Island, IL
  • NPI 1316030034

  Ophthalmology

  NPD (past)
• Eye Surgeons Associates PC

  • Ophthalmology Physician
  • Bettendorf, IA
  • NPI 1386607562
  NPD (past)
• Trinity Medical Center

  • Emergency Medicine Physician
  • Rock Island, IL
  • NPI 1568414134
  NPD (past)

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545264000000",
    "number": "1346207339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 24TH AVE S",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372122637",
            "fax_number": "563-328-5694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 24TH AVE S",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37212",
            "telephone_number": "615-875-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4731 45th Street Ct",
            "address_purpose": "LOCATION",
            "city": "Rock Island",
            "state": "IL",
            "postal_code": "612017102",
            "country_code": "US",
            "telephone_number": "563-323-2020 x1076",
            "fax_number": "563-328-5694",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENMATCHA",
        "first_name": "RAZ",
        "middle_name": "DILIP",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2018-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "202259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IA GROUP MEDICARE",
            "identifier": "26568",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL GROUP MEDICARE",
            "identifier": "790730",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS LICENSE",
            "identifier": "036-104091",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evan Michael Pendygraft, OTD, OTR/L
• Lindsey Noelle Peng-Waters, MD
• Jessica Elaine Penick
• Hannah Penler
• William C Penley, M.D.
• Courtney Alexis Penn, M.D.
• Elizabeth Penn
• Milton Earl Penn, DPM
• Roslyn Revella Penn, MS PSYCHOLOGY
• Stephanie Pennacchia, MS

• Ophthalmology Physician in Nashville, TN
• Providers in Nashville, TN by specialty
• Ophthalmology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2018; 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.