Active NPI
Venkat Krishna Rajasurya, M.D., MPH
- Pulmonary Disease Physician
- Winston Salem, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- MD61034745
- Practice address
- 3001 Lyndhurst Ave
Winston Salem, NC 27103 - Phone
- (336) 765-0383
- Fax
- (336) 760-6918
- NPI assigned
- Jul 11, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 036-130003 | IL | |
| Pulmonary Disease Physician | 207RP1001X | 201900047 | NC | |
| Pulmonary Disease Physician | 207RP1001X | MD61034745 | WA | Primary |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 201900047 | NC |
Addresses
Primary practice location
3001 Lyndhurst Ave
Winston Salem, NC 27103
Mailing address
3001 Lyndhurst Ave
Winston Salem, NC 27103-4007
Phone (336) 765-0383
Other practice location 1
2300 N Edward St
Decatur, IL 62526-4163
Phone (217) 876-4200
Other practice location 2
3001 Lyndhurst Ave
Winston Salem, NC 27103
Phone (336) 765-0383
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pulmonary Disease
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
202 N Division St
Auburn, WA 98001-4939
222 State Ave N
Kent, WA 98030-4544
Phone (253) 372-7788
311 S L St
Tacoma, WA 98405-3720
407 14TH Ave SE
Puyallup, WA 98372-3770
Phone (253) 697-1962
4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706
Hospital & facility affiliations
- Multicare Good Samaritan Hospital
- Multicare Auburn Medical Center
- Tacoma General Allenmore Hospital
- Multicare Covington Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201900047 | NC | MD | Critical Care Medicine (Internal Medicine) Physician |
| MD61034745 | WA | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Multicare Health System | Current | Accepting new patients | |
| Multicare Health System | Current | Accepting new patients | |
| Multicare Health System | Current | Accepting new patients | |
| Multicare Health System | Past | Accepting new patients | |
| Multicare Health System | Past | Accepting new patients | |
| Multicare Health System | Past | Accepting new patients | |
| Multicare Health System | Past | Accepting new patients |
Locations
4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590
222 State Ave N
Kent, WA 98030
Phone (253) 372-7680
311 S L St
Tacoma, WA 98405
Phone (253) 403-1444
Interoperability endpoints
- vrajasurya489986@direct.multicare.org
Organizations & group practices 7
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.
-
- Neurological Surgery Physician
- Tacoma, WA
- NPI 1497766638
-
- Family Medicine Physician
- Covington, WA
- NPI 1093768657
-
- Community/Retail Pharmacy
- Spokane, WA
- NPI 1396594875
-
- Family Medicine Physician
- Auburn, WA
- NPI 1013969195
-
- General Acute Care Hospital
- Tacoma, WA
- NPI 1114972791
-
- General Acute Care Hospital
- Auburn, WA
- NPI 1255327201
-
- General Acute Care Hospital
- Puyallup, WA
- NPI 1841231461
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Auburn, WA
- NPI 1255327201
-
- General Acute Care Hospital
- Covington, WA
- NPI 1326564071
-
- General Acute Care Hospital
- Tacoma, WA
- NPI 1366556227
-
- General Acute Care Hospital
- Puyallup, WA
- NPI 1841231461
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594771200000",
"number": "1669601662",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3001 LYNDHURST AVE",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271034007",
"telephone_number": "336-765-0383",
"fax_number": "336-760-6918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3001 LYNDHURST AVE",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "27103",
"telephone_number": "336-765-0383",
"fax_number": "336-760-6918"
}
],
"practiceLocations": [
{
"address_1": "2300 N Edward St",
"address_purpose": "LOCATION",
"city": "Decatur",
"state": "IL",
"postal_code": "625264163",
"country_code": "US",
"telephone_number": "217-876-4200",
"fax_number": "217-876-4209",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3001 Lyndhurst Ave",
"address_purpose": "LOCATION",
"city": "Winston Salem",
"state": "NC",
"postal_code": "27103",
"country_code": "US",
"telephone_number": "336-765-0383",
"fax_number": "336-760-6918",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RAJASURYA",
"first_name": "VENKAT KRISHNA",
"name_prefix": "Dr.",
"credential": "M.D., MPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-11",
"last_updated": "2020-07-15",
"certification_date": "2020-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "IL",
"license": "036-130003",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "NC",
"license": "201900047",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "WA",
"license": "MD61034745",
"primary": true
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "NC",
"license": "201900047",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; 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.