NPIMap

Individual provider Active NPI

Prathap Raviraj, MD

  • Internal Medicine Physician
  • Saint Paul, MN
National Provider Identifier
1619127057
Registry record updated Oct 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
53970 Issued in MN
Practice address
640 Jackson St
Saint Paul, MN 55101-2502
Phone
(651) 254-3456
Fax
(651) 254-9673
NPI assigned
Sep 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2016

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 53970 MN Primary

Addresses

Primary practice location

640 Jackson St
Saint Paul, MN 55101-2502

Mailing address

PO Box 1309
Mail Stop 21110Q
Minneapolis, MN 55440-1309
Phone (651) 254-3456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20110725000181 MN Practitioner - Internal MedicinePractitioner - Hospitalist 3577731256 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 863-4000

4050 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2522
Phone (763) 236-6000

520 Osborne Rd NE
Fridley, MN 55432-2718

550 Osborne Rd NE
Fridley, MN 55432-2718
Phone (763) 427-9980

701 Dellwood St S
Cambridge, MN 55008-1920
Phone (763) 689-8700

PO Box
Minneapolis, MN 55440-0043

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Jan 3, 2022 Accepting new patients
Allina Health System Internal Medicine CurrentSince Jan 3, 2022 Accepting new patients
Hutchinson Health CurrentSince Apr 1, 2019 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System Past Accepting new patients
Allina Health System Past Accepting new patients

Locations

1029 Highway 15 S
Hutchinson, MN 55350
Phone (320) 275-3358

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

Organizations & group practices 6

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 38

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475798400000",
    "number": "1619127057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1309",
            "address_2": "MAIL STOP 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554401309",
            "telephone_number": "651-254-3456",
            "fax_number": "651-254-9673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-3456",
            "fax_number": "651-254-9673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVIRAJ",
        "first_name": "PRATHAP",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-23",
        "last_updated": "2016-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "53970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.