Individual provider Active NPI

Shiv Raj, M.D.

  • Interventional Cardiology Physician
  • Brooklyn, NY
National Provider Identifier
1386062867
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
304540 Issued in NY
Practice address
4802 10TH Avenue
Maimonides Medical Center
Brooklyn, NY 11219
Phone
(718) 283-8000
NPI assigned
Apr 2, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 304540 NY Primary

Addresses

Primary practice location

4802 10TH Avenue
Maimonides Medical Center
Brooklyn, NY 11219

Mailing address

4802 10TH Avenue
Maimonides Medical Center
Brooklyn, NY 11219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20220912002183 NY Practitioner - Cardiovascular Disease (Cardiology) 1557605409 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physicians of Brooklyn, Inc.Group PAC ID 0749192284, 174 clinicians
Maimonides Cardiology FPPGroup PAC ID 4688814809, 42 clinicians

Practice addresses (Care Compare)

450 Clarkson Ave
Brooklyn, NY 11203-2012
Phone (718) 826-4959

4802 10TH Ave
Brooklyn, NY 11219-2916
Phone (718) 283-7735

Hospital & facility affiliations

  • Maimonides Medical Center Hospital, Brooklyn, NY, CCN 330194
  • Suny/Downstate University Hospital of Brooklyn Hospital, Brooklyn, NY, CCN 330350
  • New York Community Hospital of Brooklyn, Inc. Hospital, Brooklyn, NY, CCN 330019

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting14

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians of Brooklyn, Inc. Interventional Cardiology CurrentSince Sep 15, 2024 Accepting new patients
University Physicians of Brooklyn, Inc. Current Accepting new patients
Advantagecare Physicians PC CurrentSince Aug 16, 2023 Accepting new patients
Maimonides Medical Center Maimonides Primary Care FPP CurrentSince Jul 1, 2022 Accepting new patients
University Physicians of Brooklyn, Inc. CurrentSince Sep 15, 2024 Accepting new patients
Maimonides Faculty Practice Plan CurrentSince Jul 1, 2022 Accepting new patients
Advantagecare Physicians PC CurrentSince Aug 16, 2023 Accepting new patients
Maimonides Cardiology FPP CurrentSince Jul 1, 2022 Accepting new patients
Maimonides Medical Center Past Accepting new patients

Locations

233 Nostrand Ave
Brooklyn, NY 11205
Phone (646) 680-1595

447 Atlantic Ave
Brooklyn, NY 11217
Phone (718) 421-2131

101 Pennsylvania Ave
Brooklyn, NY 11207
Phone (718) 240-2000

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

450 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 270-1603

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: shiv.raj.p1@direct.mmc.nextgenshare.com
  • FHIR API: https://epwebapps.acpny.com/FHIRproxy/ACPNY/api/FHIR/R4
  • Direct secure messaging: sraj8158612@nychhc.direct-ci.com

Organizations & group practices 9

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1396396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1386062867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4802 10TH AVENUE",
            "address_2": "MAIMONIDES MEDICAL CENTER",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 10TH AVENUE",
            "address_2": "MAIMONIDES MEDICAL CENTER",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11219",
            "telephone_number": "718-283-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJ",
        "first_name": "SHIV",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-02",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NY",
            "license": "304540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.