Individual provider Active NPI

Vivek Raj, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Bowie, MD
National Provider Identifier
1447631684
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
H97600 Issued in MD
Practice address
17351 Melford Blvd
Bowie, MD 20715-4457
Phone
(240) 548-1300
NPI assigned
Jun 13, 2015
Last updated
Aug 30, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X 34.013937 OH
Physical Medicine & Rehabilitation Physician 208100000X OP61113387 WA
Physical Medicine & Rehabilitation Physician 208100000X H97600 MD Primary

Addresses

Primary practice location

17351 Melford Blvd
Bowie, MD 20715-4457

Mailing address

7156 Tranquility Rd
Laurel, MD 20723-2098
Phone (919) 597-1118

Other practice location 1

4389 Medina Rd
Copley, OH 44321-1388
Phone (234) 815-5100

Other practice location 2

1 Medical Center Dr
Suite 162
Stratford, NJ 08084-1500
Phone (856) 566-6708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220119001525 TX Practitioner - Physical Medicine and Rehabilitation 0648562033
I20230818001426 DC Practitioner - Physical Medicine and Rehabilitation 0648562033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vivek Raj LLCGroup PAC ID 4183086465, 3 clinicians

Practice addresses (Care Compare)

17351 Melford Blvd
Bowie, MD 20715-4457
Phone (240) 548-1300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H97600MDMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vivek Raj LLC Single Specialty CurrentSince Jun 16, 2023 Accepting new patients
Encompass Health Rehabilitation Hospital of Southern Maryland, LLC Past Accepting new patients

Locations

415 W Golf Rd
Ste 26
Arlington Hts, IL 60005

17351 Melford Blvd
Bowie, MD 20715
Phone (240) 548-1300

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1434153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1447631684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7156 TRANQUILITY RD",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207232098",
            "telephone_number": "919-597-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17351 MELFORD BLVD",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207154457",
            "telephone_number": "240-548-1300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4389 Medina Rd",
            "address_purpose": "LOCATION",
            "city": "Copley",
            "state": "OH",
            "postal_code": "443211388",
            "country_code": "US",
            "telephone_number": "234-815-5100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Medical Center Dr",
            "address_2": "Suite 162",
            "address_purpose": "LOCATION",
            "city": "Stratford",
            "state": "NJ",
            "postal_code": "080841500",
            "country_code": "US",
            "telephone_number": "856-566-6708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAJ",
        "first_name": "VIVEK",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-13",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OH",
            "license": "34.013937",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WA",
            "license": "OP61113387",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MD",
            "license": "H97600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

Verify at the official NPI Registry.