Individual provider Active NPI

Raghu Midde, MD

  • Pulmonary Disease Physician
  • Daly City, CA
National Provider Identifier
1366597437
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
A77892 Issued in CA
Practice address
901 Campus Dr
Ste 308
Daly City, CA 94015-4900
Phone
(650) 991-0600
Fax
(650) 991-0306
NPI assigned
Jan 25, 2007
Last updated
Dec 17, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X A77892 CA Primary

Addresses

Primary practice location

901 Campus Dr
Ste 308
Daly City, CA 94015-4900

Mailing address

901 Campus Dr
Ste 308
Daly City, CA 94015-4900
Phone (650) 991-0600

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040116000686 CA Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 4486555026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

1100 Veterans Blvd
Redwood City, CA 94063-2037
Phone (650) 299-2000

1150 Veterans Blvd
Redwood City, CA 94063-2037
Phone (650) 299-2000

1190 Veterans Blvd
Redwood City, CA 94063-2037
Phone (650) 299-2000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
77894CAMDPharmacist
A77892CAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Current Accepting new patients
Permanente Medical Group Inc CurrentSince Oct 6, 2010 Accepting new patients
Permanente Medical Group, Inc CurrentSince Oct 6, 2010 Accepting new patients
Hospitalist Medicine Physicians of California, Inc Past Accepting new patients
Rancho Faculty Medical Associates, Inc. Past Accepting new patients

Locations

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1366597437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 CAMPUS DR",
            "address_2": "STE 308",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940154900",
            "telephone_number": "650-991-0600",
            "fax_number": "650-991-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 CAMPUS DR",
            "address_2": "STE 308",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940154900",
            "telephone_number": "650-991-0600",
            "fax_number": "650-991-0306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDE",
        "first_name": "RAGHU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A77892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1150 Veterans Blvd",
            "city": "Redwood City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "940632037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Daly City, CA

Sources for this page

Verify at the official NPI Registry.