Individual provider Active NPI

Muralidhara R Raju, M.D.

  • Neurological Surgery Physician
  • Boise, ID
National Provider Identifier
1689738783
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
M-17340 Issued in ID
Practice address
190 E Bannock St FL 10
Boise, ID 83712-6241
Phone
(208) 381-5500
NPI assigned
Dec 21, 2006
Last updated
Jul 31, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X A100400 CA
Neurological Surgery Physician 207T00000X M-17340 ID Primary
Orthopaedic Surgery of the Spine Physician 207XS0117X A100400 CA

Addresses

Primary practice location

190 E Bannock St FL 10
Boise, ID 83712-6241

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Other practice location 1

11190 Warner Ave
Suite 305
Fountain Valley, CA 92708-4019
Phone (714) 433-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, ID2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080103000337 CA Practitioner - Neurology 3476659632 Reassigns benefits to 1 organization
I20230911000400 ID Practitioner - Neurosurgery 3476659632 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Northwestern University Feinberg Medical School, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

100 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2983

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-9384

222 N 2ND St
Boise, ID 83702-6130

608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
81.29
Promoting interoperability
100
Improvement activities
40
Cost
76.37

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A100400CAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Monterey Behavioral Health CurrentSince Jul 14, 2018 Accepting new patients
County of Monterey CurrentSince Jul 14, 2018 Accepting new patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Jul 31, 2023 Accepting new patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Jul 31, 2023 Accepting new patients
Orthopaedic Clinical Assoc Inc. PastSince Aug 1, 2008 Accepting new patients
St Lukes Regional Medical Center PastSince Aug 6, 2023 Accepting new patients

Locations

1441 Constitution Blvd
Salinas, CA 93906
Phone (831) 261-8090

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

190 E Bannock St
Fl 10
Boise, ID 83712
Phone (208) 381-5500

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

Organizations & group practices 6

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.

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": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1689738783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "fax_number": "714-433-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST FL 10",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-381-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11190 Warner Ave",
            "address_2": "Suite 305",
            "address_purpose": "LOCATION",
            "city": "Fountain Valley",
            "state": "CA",
            "postal_code": "927084019",
            "country_code": "US",
            "telephone_number": "714-433-2000",
            "fax_number": "714-433-2901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAJU",
        "first_name": "MURALIDHARA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "A100400",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "ID",
            "license": "M-17340",
            "primary": true
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "A100400",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.