Individual provider Active NPI

Rajinder M. Gulati, MD

  • Nuclear Radiology Physician
  • Cape Girardeau, MO
National Provider Identifier
1639183940
Registry record updated Nov 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Radiology PhysicianTaxonomy code 2085N0904X
License
2005023119 Issued in MO
Practice address
70 Doctors Park
Cape Girardeau, MO 63703-4928
Phone
(573) 334-6071
Fax
(573) 334-4739
NPI assigned
Jul 29, 2006
Last updated
Nov 13, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Radiology Physician 2085N0904X 2005023119 MO Primary
Diagnostic Radiology Physician 2085R0202X 2005023119 MO

Addresses

Primary practice location

70 Doctors Park
Cape Girardeau, MO 63703-4928

Mailing address

70 Doctors Park
Cape Girardeau, MO 63703-4928
Phone (573) 334-6071

Other identifiers 7

IdentifierTypeStateIssuer
185214OtherMO BLUE CROSS BLUE SHIELD
207354705MedicaidMO
430954380CAPOtherMERCY HEALTH PLAN
036-660634OtherILIL BLUE CROSS BLUE SHIELD
063896OtherHEALTH ALLIANCE
123361OtherHEALTHLINK
036060634-4MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2005023119MOMDDiagnostic Radiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384300800000",
    "number": "1639183940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 DOCTORS PARK",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034928",
            "telephone_number": "573-334-6071",
            "fax_number": "573-334-4739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 DOCTORS PARK",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034928",
            "telephone_number": "573-334-6071",
            "fax_number": "573-334-4739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULATI",
        "first_name": "RAJINDER",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-29",
        "last_updated": "2013-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "MO",
            "license": "2005023119",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2005023119",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO BLUE CROSS BLUE SHIELD",
            "identifier": "185214",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207354705",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY HEALTH PLAN",
            "identifier": "430954380CAP",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL BLUE CROSS BLUE SHIELD",
            "identifier": "036-660634",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "063896",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "123361",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036060634-4",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.