NPIMap

Individual provider Active NPI

Kavita Raj, DO

  • Family Medicine Physician
  • Marion, IN
National Provider Identifier
1669456059
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02001903 Issued in IN
Practice address
1399 N Baldwin Avenue
Marion, IN 46952-7550
Phone
(765) 660-7550
Fax
(765) 662-4467
NPI assigned
Nov 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 02001903 IN Primary

Addresses

Primary practice location

1399 N Baldwin Avenue
Marion, IN 46952-7550

Mailing address

330 N Wabash Ave Ste G-20
Marion, IN 46952-2605
Phone (765) 660-7600

Other identifiers 2

IdentifierTypeStateIssuer
200170890MedicaidIN
000000763629OtherINANTHEM

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kavita.raj@mgh.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20080402000156 IN Practitioner - Family Practice 8022195098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marion General HospitalGroup PAC ID 9133023625, 115 clinicians

Practice addresses (Care Compare)

4781 Kaybee Dr
Gas City, IN 46933-6607
Phone (765) 660-7840

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.82 of 100Reported as group
Quality
71.45
Promoting interoperability
100
Improvement activities
40
Cost
75.59

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02001903INMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marion General Hospital Family Medicine CurrentSince Jun 1, 2012 Accepting new patients
Marion General Hospital CurrentSince Jun 1, 2012 Accepting new patients

Locations

4781 Kaybee Dr
Gas City, IN 46933
Phone (765) 660-7840

330 N Wabash Ave
Ste G-20
Marion, IN 46952
Phone (765) 660-7600

441 N Wabash Ave
Marion, IN 46952
Phone (219) 482-4577

330 N Wabash Ave
Ste 370
Marion, IN 46952
Phone (765) 660-7500

1251 W Kem Rd
Ste B
Marion, IN 46952
Phone (765) 662-8696

1399 N Baldwin Ave
Marion, IN 46952
Phone (765) 651-2620

Interoperability endpoints

  • Direct secure messaging: kavita.raj@mgh.eclinicaldirectplus.com

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 9

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": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1669456059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N WABASH AVE STE G-20",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469522605",
            "telephone_number": "765-660-7600",
            "fax_number": "765-651-7313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1399 N BALDWIN AVENUE",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469527550",
            "telephone_number": "765-660-7550",
            "fax_number": "765-662-4467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJ",
        "first_name": "KAVITA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02001903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200170890",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000763629",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kavita.raj@mgh.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "1399 N Baldwin Avenue",
            "city": "Marion",
            "state": "IN",
            "country_code": "US",
            "postal_code": "469527550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marion, IN

Sources for this page

Verify at the official NPI Registry.