NPIMap

Individual provider Active NPI

David Lourdu Raj, MD

  • Body Imaging Physician
  • Columbia, MO
National Provider Identifier
1508091893
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Body Imaging PhysicianTaxonomy code 2085B0100X
License
2022047337 Issued in MO
Practice address
One Hospital Dr
Columbia, MO 65212-0001
Phone
(573) 884-7770
Fax
(573) 882-9876
NPI assigned
May 15, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD453837 PA
Diagnostic Radiology Physician 2085R0202X 2022047337 MO
Body Imaging Physician 2085B0100X 2022047337 MO Primary

Addresses

Primary practice location

One Hospital Dr
Columbia, MO 65212-0001

Mailing address

PO Box 843966
Kansas City, MO 64184-3966
Phone (573) 884-3300

Other identifiers 2

IdentifierTypeStateIssuer
200117918MedicaidMO
103018404MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MUDOCREFERRAL@direct.health.missouri.edu Direct Curators of the University of Missouri

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, MO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150707001980 PA Practitioner - Diagnostic Radiology 6800028861 Reassigns benefits to 1 organization
I20230111000165 MO Practitioner - Diagnostic Radiology 6800028861 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Curators of the University of MissouriGroup PAC ID 4486759560, 1,108 clinicians

Practice addresses (Care Compare)

1 Hospital Dr
Columbia, MO 65212-0001
Phone (573) 882-4141

Hospital & facility affiliations

  • University of Missouri Health Care Hospital, Columbia, MO, CCN 260141
  • Lake Regional Health System Hospital, Osage Beach, MO, CCN 260186
  • Boone Hospital Center Hospital, Columbia, MO, CCN 260068
  • Phelps County Regional Medical Center Hospital, Rolla, MO, CCN 260017
  • Northeast Regional Medical Center Hospital, Kirksville, MO, CCN 260022

Merit-based Incentive Payment System (MIPS)

Final score
80.23 of 100Reported as group
Quality
58.17
Promoting interoperability
100
Improvement activities
40
Cost
75.92

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2022047337MOMDBody Imaging Physician
MD453837PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Curators of the University of Missouri CurrentSince Dec 21, 2022 Accepting new patients
Curators of the University of Missouri CurrentSince Dec 21, 2022 Accepting new patients
Medical Imaging of Lehigh Valley PC Diagnostic Radiology CurrentSince Jul 1, 2015 Accepting new patients

Locations

404 N Keene St
Columbia, MO 65201
Phone (573) 875-9000

1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568

1200 S Cedar Crest Blvd
Allentown, PA 18103
Phone (484) 862-3200

Organizations & group practices 3

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 10

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": "1242345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1508091893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843966",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641843966",
            "telephone_number": "573-884-3300",
            "fax_number": "573-884-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE HOSPITAL DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652120001",
            "telephone_number": "573-884-7770",
            "fax_number": "573-882-9876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJ",
        "first_name": "DAVID",
        "middle_name": "LOURDU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-15",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD453837",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2022047337",
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "MO",
            "license": "2022047337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200117918",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103018404",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MUDOCREFERRAL@direct.health.missouri.edu",
            "affiliation": "Y",
            "endpointDescription": "Endpoint is used to receive electronic continuity of care documents (C-CDA) for outpatient referrals.",
            "affiliationName": "Curators of the University of Missouri",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct",
            "address_1": "One Hospital Dr",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652120001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.