Individual provider Active NPI

Kuldeep Raj, M.D.

  • Hospitalist Physician
  • Jersey City, NJ
National Provider Identifier
1639744113
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
33393 Issued in WV
Practice address
355 Grand St
Granduate Medical Education & Internal Medicine Residen
Jersey City, NJ 07302
Phone
(201) 915-2431
Fax
(201) 915-2219
NPI assigned
May 26, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 33393 WV Primary

Addresses

Primary practice location

355 Grand St
Granduate Medical Education & Internal Medicine Residen
Jersey City, NJ 07302

Mailing address

355 Grand St
Granduate Medical Education & Internal Medicine Residen
Jersey City, NJ 07302
Phone (201) 915-2431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20241003000801 WV Practitioner - HospitalistPractitioner - Internal Medicine 5294266136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Camden-Clark Physician CorporationGroup PAC ID 5294885661, 345 clinicians

Practice addresses (Care Compare)

800 Garfield Ave
Parkersburg, WV 26101-5376
Phone (304) 424-2111

Hospital & facility affiliations

  • Camden Clark Medical Center Hospital, Parkersburg, WV, CCN 510058
  • West Virginia University Hospitals, Inc Hospital, Morgantown, WV, CCN 510001

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Camden-Clark Physician Corporation CurrentSince Aug 1, 2024 Accepting new patients
Camden Clark Memorial Hospital Corporation Past Accepting new patients

Locations

800 Garfield Ave
Parkersburg, WV 26101
Phone (304) 420-7161

800 Garfield Ave
Rm G101
Parkersburg, WV 26101
Phone (304) 422-0405

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 and National Provider Directory roles.

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": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1639744113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 GRAND ST",
            "address_2": "GRANDUATE MEDICAL EDUCATION & INTERNAL MEDICINE RESIDEN",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "07302",
            "telephone_number": "201-915-2431",
            "fax_number": "201-915-2219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 GRAND ST",
            "address_2": "GRANDUATE MEDICAL EDUCATION & INTERNAL MEDICINE RESIDEN",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "07302",
            "telephone_number": "201-915-2431",
            "fax_number": "201-915-2219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJ",
        "first_name": "KULDEEP",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-26",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WV",
            "license": "33393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.