Individual provider Active NPI

Lekshminarayan Raghavakurup, M.D

  • Internal Medicine Physician
  • Scranton, PA
National Provider Identifier
1558631390
Registry record updated Jan 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MT 198537 Issued in PA
Practice address
2000 Tall Trees Dr
504 Tall Trees Apt
Scranton, PA 18505-2204
Phone
(570) 468-4865
NPI assigned
Jan 11, 2012
Last updated
Jan 11, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT 198537 PA Primary

Addresses

Primary practice location

2000 Tall Trees Dr
504 Tall Trees Apt
Scranton, PA 18505-2204

Mailing address

2000 Tall Trees Dr
504 Tall Trees Apt
Scranton, PA 18505-2204
Phone (570) 468-4865

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20140818000874 MD Practitioner - Internal Medicine 7517184492 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
May accept Medicare assignment
Group practices
Sinai Hospital of Baltimore, IncGroup PAC ID 0941112346, 373 clinicians

Practice addresses (Care Compare)

2401 E Belvedere Ave
Baltimore, MD 21215-5216

2435 W Belvedere Ave
Baltimore, MD 21215-5224

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
62.93 of 100Reported as individual
Quality
36.53
Improvement activities
40
Cost
59.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT 198537PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sinai Hospital of Baltimore Inc Current Accepting new patients
Sinai Hospital of Baltimore Inc Internal Medicine CurrentSince Jul 10, 2014 Accepting new patients
Sinai Hospital of Baltimore, Inc. CurrentSince Jul 10, 2014 Accepting new patients

Locations

2401 W Belvedere Ave
Ofc
Baltimore, MD 21215
Phone (410) 601-1544

2435 W Belvedere Ave
Ste 56
Baltimore, MD 21215
Phone (410) 578-8632

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

Hospital & facility affiliations 3

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": "1326240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326240000000",
    "number": "1558631390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 TALL TREES DR",
            "address_2": "504 TALL TREES APT",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185052204",
            "telephone_number": "570-468-4865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 TALL TREES DR",
            "address_2": "504 TALL TREES APT",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185052204",
            "telephone_number": "570-468-4865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGHAVAKURUP",
        "first_name": "LEKSHMINARAYAN",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-11",
        "last_updated": "2012-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT 198537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.