Organization Active NPI

Guruprasad Raju, MD, PLLC

  • Internal Medicine Physician
  • Tucson, AZ
National Provider Identifier
1356459044
Registry record updated Nov 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
28771 Issued in AZ
Legal business name
GURUPRASAD RAJU, MD, PLLC
Practice address
7383 E Tanque Verde Rd
Tucson, AZ 85715-3475
Phone
(520) 318-3434
Fax
(520) 318-3435
NPI assigned
Aug 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2007

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

Authorized official

Name
Guruprasad Raju, MDNPI 1194831784
Title
President
Phone
(520) 318-3434

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 28771 AZ Primary

Addresses

Primary practice location

7383 E Tanque Verde Rd
Tucson, AZ 85715-3475

Mailing address

PO Box 43160
Tucson, AZ 85733-3160
Phone (520) 722-3777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040621000234 AZ Part B Supplier - Clinic/Group Practice 3971588492 Receives reassigned benefits from 1 practitioner
Practice locations: Tucson, AZ

National Provider Directory

National Provider Directory

Locations

820 E Tucson Marketplace Blvd
Tucson, AZ 85713

310 N Wilmot Rd
Ste 203
Tucson, AZ 85711
Phone (520) 290-8480

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194307200000",
    "number": "1356459044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43160",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857333160",
            "telephone_number": "520-722-3777",
            "fax_number": "520-296-6224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7383 E TANQUE VERDE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857153475",
            "telephone_number": "520-318-3434",
            "fax_number": "520-318-3435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GURUPRASAD RAJU, MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2007-11-06",
        "status": "A",
        "authorized_official_last_name": "RAJU",
        "authorized_official_first_name": "GURUPRASAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "520-318-3434",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "28771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.