Individual provider Active NPI

Chengalroyan Raghunathan, MD

  • Interventional Cardiology Physician
  • Paramount, CA
National Provider Identifier
1407904089
Registry record updated Oct 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
A303390 Issued in CA
Practice address
16660 Paramount Blvd Ste 202
Paramount, CA 90723-5457
Phone
(562) 663-9191
Fax
(562) 663-9111
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2015

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 A303390 CA Primary

Addresses

Primary practice location

16660 Paramount Blvd Ste 202
Paramount, CA 90723-5457

Mailing address

16660 Paramount Blvd Ste 202
Paramount, CA 90723-5457
Phone (562) 663-9191

Other identifiers 2

IdentifierTypeStateIssuer
953548420OtherCATAX ID
00A303390MedicaidCA

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
I20090108000398 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - General PracticePractitioner - Internal Medicine 4880757418

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A303390CAMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
C Raghunathan MD Inc CurrentSince Jul 24, 2015 Accepting new patients
R Srinivasan MD Inc Past Accepting new patients

Locations

16660 Paramount Blvd
Ste 202
Paramount, CA 90723
Phone (562) 663-3131

16660 Paramount Blvd
Ste 2
Paramount, CA 90723
Phone (562) 663-9191

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445904000000",
    "number": "1407904089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16660 PARAMOUNT BLVD STE 202",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "907235457",
            "telephone_number": "562-663-9191",
            "fax_number": "562-663-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16660 PARAMOUNT BLVD STE 202",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "907235457",
            "telephone_number": "562-663-9191",
            "fax_number": "562-663-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGHUNATHAN",
        "first_name": "CHENGALROYAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2015-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "A303390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "953548420",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A303390",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paramount, CA

Sources for this page

Verify at the official NPI Registry.