NPIMap

Individual provider Active NPI

Prajay Rathore, M.D

  • Internal Medicine Physician
  • Danbury, CT
National Provider Identifier
1417410887
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
75662 Issued in CT
Practice address
70 Main St
Danbury, CT 06810-7832
Phone
(203) 743-0100
NPI assigned
Apr 11, 2019
Last updated
Jan 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 291275 MA
Internal Medicine Physician 207R00000X 75662 CT Primary

Addresses

Primary practice location

70 Main St
Danbury, CT 06810-7832

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (800) 222-5088

Other practice location 1

370 Lunenburg St
Fitchburg, MA 01420-4541
Phone (978) 342-6018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240301002250 CT Practitioner - Internal Medicine 4789915505 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Optimus Health Care IncGroup PAC ID 9335051580, 79 clinicians

Practice addresses (Care Compare)

120 Main St
Danbury, CT 06810-7834
Phone (203) 743-9760

471 Barnum Ave
Bridgeport, CT 06608-2409
Phone (203) 576-3885

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
82.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
1O1 Review Series, LLC Internal Medicine Current Accepting new patients
Connecticut Institute for Communities Inc CurrentSince Feb 1, 2024 Accepting new patients
Connecticut Institute for Communities Inc CurrentSince Feb 1, 2024 Accepting new patients
Optimus Health Care Inc Past Accepting new patients

Locations

120 Main St
Danbury, CT 06810
Phone (203) 456-1406

120 Main St
Fl 4
Danbury, CT 06810
Phone (203) 456-1405

152 West St
Danbury, CT 06810
Phone (203) 791-5120

57 North St
Ste 103
Danbury, CT 06810
Phone (203) 744-7007

70 Main St
Danbury, CT 06810
Phone (203) 739-8100

Interoperability endpoints

  • Direct secure messaging: prajay.rathore@gdchc.eclinicaldirectplus.com

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1554940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1417410887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-222-5088",
            "fax_number": "083-341-9775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 MAIN ST",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068107832",
            "telephone_number": "203-743-0100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "370 Lunenburg St",
            "address_purpose": "LOCATION",
            "city": "Fitchburg",
            "state": "MA",
            "postal_code": "014204541",
            "country_code": "US",
            "telephone_number": "978-342-6018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RATHORE",
        "first_name": "PRAJAY",
        "name_prefix": "Mr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-11",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "291275",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "75662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.