Individual provider Active NPI

Taufiek Konrad Rajab, M.B. B.CHIR

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Little Rock, AR
National Provider Identifier
1689800872
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
E-17168 Issued in AR
Practice address
1 Childrens Way # 653
Little Rock, AR 72202-3500
Phone
(501) 364-1100
Fax
(501) 364-4082
NPI assigned
Jun 2, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X 84041 SC
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X E-17168 AR Primary

Addresses

Primary practice location

1 Childrens Way # 653
Little Rock, AR 72202-3500

Mailing address

1 Childrens Way # 653
Little Rock, AR 72202-3500
Phone (501) 364-1100

Other practice location 1

171 Ashley Ave
Charleston, SC 29425-6110
Phone (843) 792-1414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, AR2 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
I20200903000856 SC Practitioner - Cardiac Surgery 5991943839 Reassigns benefits to 1 organization
I20231130002566 AR Practitioner - Thoracic Surgery 5991943839 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Childrens Hospital CurrentSince Nov 1, 2023 Accepting new patients
Arkansas Childrens Professional Services Organization LLC CurrentSince Jul 1, 2025 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Aug 13, 2020 Accepting new patients
University of Arkansas for Medical Sciences Pediatric Surgery Current Accepting new patients
Arkansas Children'S Hospital CurrentSince Nov 1, 2023 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Nov 1, 2023 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Aug 13, 2020 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Nov 1, 2023 Accepting new patients

Locations

1 Childrens Way
#664
Little Rock, AR 72202
Phone (501) 364-2505

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

1 Childrens Way
Ste 653
Little Rock, AR 72202

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1689800872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1100",
            "fax_number": "501-364-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1100",
            "fax_number": "501-364-4082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "171 Ashley Ave",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294256110",
            "country_code": "US",
            "telephone_number": "843-792-1414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAJAB",
        "first_name": "TAUFIEK",
        "middle_name": "KONRAD",
        "name_prefix": "Dr.",
        "credential": "M.B. B.CHIR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-02",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "SC",
            "license": "84041",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "AR",
            "license": "E-17168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.