Phillip Thomas Rajadas, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

39112 Issued in CO

Practice address

201 S McCulloch Blvd
Pueblo West, CO 81007-2892

Phone

(719) 561-5377

Fax

(719) 561-5378

NPI assigned

Aug 15, 2005

Last updated

Aug 6, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Star Rehab Prof Physicians, LLC

  dba Star Rehab, LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Pueblo West, CO
  • NPI 1922000421
  NPD (past)
• Star Rehab Therapy LLC

  • Physical Therapist
  • Pueblo, CO
  • NPI 1972564110
  NPD (past)

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249516800000",
    "number": "1346242872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8867",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810088867",
            "telephone_number": "719-561-5377",
            "fax_number": "719-561-5378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S MCCULLOCH BLVD",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "810072892",
            "telephone_number": "719-561-5377",
            "fax_number": "719-561-5378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJADAS",
        "first_name": "PHILLIP",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2009-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CO",
            "license": "39112",
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CO",
            "license": "39112",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "KS",
            "license": "04-31652",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00281502",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200362640A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13777777",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pure Spa & Wellness
• Pursuit of Happiness Counseling, LLC
• Kiaha Quint
• Brita Faye Radzymski
• Laura Jeanne Ragulsky, RN
• Michael Joseph Ramos, MD
• Heather Lynn Ramsey, COTA
• Laura Reinert, PSYD
• Renewed Mind Mental Health LLC
• Renewed Mind Mental Health LLC

• Physical Medicine & Rehabilitation Physician in Pueblo West, CO
• Providers in Pueblo West, CO by specialty
• Physical Medicine & Rehabilitation Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2009; 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.