Rama K Muddaraj, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

13089 Issued in AZ

Practice address

13555 W. McDowell Rd.
Suite 204
Goodyear, AZ 85395-2626

Phone

(623) 247-0300

Fax

(623) 247-9268

NPI assigned

Jun 3, 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 2

Other names 1

• M K Ramachandra Former name

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Southwest Valley Surgical Associates, PLLC

  • Surgery Physician
  • Goodyear, AZ
  • NPI 1528413929
  Medicare reassignment NPD
• Rama K Muddaraj MD PC

  • Surgery Physician
  • Goodyear, AZ
  • NPI 1699880336
  NPD (past) Authorized official
• Privia Medical Group Arizona, LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1760441141

  Surgery

  NPD (past)

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463097600000",
    "number": "1386682227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13555 W. MCDOWELL RD.",
            "address_2": "SUITE 204",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952626",
            "telephone_number": "623-247-0300",
            "fax_number": "623-247-9268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13555 W. MCDOWELL RD.",
            "address_2": "SUITE 204",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952626",
            "telephone_number": "623-247-0300",
            "fax_number": "623-247-9268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDDARAJ",
        "first_name": "RAMA",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2016-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "13089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "226060",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "226060",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "M",
            "last_name": "RAMACHANDRA",
            "middle_name": "K",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Surgery Physician in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.