Individual provider Active NPI

Rajan Sareen, MD

  • Internal Medicine Physician
  • Fort Myers, FL
National Provider Identifier
1659368934
Registry record updated Dec 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0053094 Issued in FL
Practice address
4801 Palm Beach Blvd
Fort Myers, FL 33905-3214
Phone
(239) 694-2161
Fax
(239) 694-4131
NPI assigned
Oct 3, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2009

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 ME0053094 FL Primary

Addresses

Primary practice location

4801 Palm Beach Blvd
Fort Myers, FL 33905-3214

Mailing address

PO Box 51108
Fort Myers, FL 33994-1108
Phone (239) 694-2161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110517000623 FL Practitioner - Internal Medicine 9234315789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1975
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4801 -Palm Beach Blvd
Fort Myers, FL 33905-3214
Phone (239) 694-2161

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0053094FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rajan Sareen MD PLLC CurrentSince Apr 10, 2019 Accepting new patients

Locations

4801 Palm Beach Blvd
Fort Myers, FL 33905
Phone (239) 313-5427

4801 Palm Beach Blvd
#K
Fort Myers, FL 33905

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

NPI Registry JSON

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259798400000",
    "number": "1659368934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51108",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339941108",
            "telephone_number": "239-694-2161",
            "fax_number": "239-694-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 PALM BEACH BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339053214",
            "telephone_number": "239-694-2161",
            "fax_number": "239-694-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAREEN",
        "first_name": "RAJAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2009-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0053094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.