Active NPI
Thivisa Rajagopal, M.D.
- Family Medicine Physician
- Canton, NY
National Provider Identifier
1659723005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 300516
- Practice address
- 80 E Main St
Canton, NY 13617-1450 - Phone
- (724) 223-3100
- NPI assigned
- Jul 11, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MT211844 | PA | |
| Family Medicine Physician | 207Q00000X | 300516 | NY | Primary |
Addresses
Primary practice location
80 E Main St
Canton, NY 13617-1450
Mailing address
50 Leroy St
Potsdam, NY 13676-1799
Phone (315) 265-3300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191216001984 | NY | Practitioner - Family Practice | 2062790983 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Canton-Potsdam Hospital
Practice addresses (Care Compare)
80 E Main St
Canton, NY 13617-1450
Phone (315) 386-3300
Hospital & facility affiliations
- Health Services of Northern New York Inc Chha
- Northern Lights Home Health Care
- Canton-Potsdam Hospital
- SLHS Massena, Inc
- Gouverneur Hospital
- Carthage Area Hospital, Inc
Merit-based Incentive Payment System (MIPS)
- Final score
- 98.56 of 100
- Quality
- 87.76
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT211844 | PA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Canton-Potsdam Hospital | Current | Accepting new patients | |
| Canton-Potsdam Hospital | Current | Accepting new patients | |
| Canton Potsdam Hospital | Past | Accepting new patients |
Locations
80 E Main St
Canton, NY 13617
Phone (315) 261-6034
50 Leroy St
Potsdam, NY 13676
Phone (315) 261-6034
201 Market St
Ste E
Potsdam, NY 13676
Phone (315) 274-9102
Interoperability endpoints
- trajagopal338582@direct.rochesterregional.org
Organizations & group practices 4
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.
-
- Medicare Defined Swing Bed Hospital Unit
- Potsdam, NY
- NPI 1114104445
-
- Physical Therapy Clinic/Center
- Canton, NY
- NPI 1770703522
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Potsdam, NY
- NPI 1952407033
-
- Home Health Agency
- Canton, NY
- NPI 1881037604
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574726400000",
"number": "1659723005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 LEROY ST",
"city": "POTSDAM",
"state": "NY",
"postal_code": "136761799",
"telephone_number": "315-265-3300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 E MAIN ST",
"city": "CANTON",
"state": "NY",
"postal_code": "136171450",
"telephone_number": "724-223-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAJAGOPAL",
"first_name": "THIVISA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-11",
"last_updated": "2019-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "MT211844",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "300516",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.