Individual provider Active NPI

Rahul Raja Valluru, M.D.

  • Internal Medicine Physician
  • Jackson Heights, NY
National Provider Identifier
1689938763
Registry record updated May 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
291911 Issued in NY
Practice address
3720 77TH St Apt 2F
Jackson Heights, NY 11372
Phone
(646) 421-0537
NPI assigned
Jul 3, 2012
Last updated
May 12, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 291911 NY Primary
Nephrology Physician 207RN0300X 291911 NY

Addresses

Primary practice location

3720 77TH St Apt 2F
Jackson Heights, NY 11372

Mailing address

3720 77TH St Apt 2F
Jackson Heights, NY 11372-6630
Phone (646) 421-0537

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180409000071 NY Practitioner - HospitalistPractitioner - NephrologyPractitioner - Internal Medicine 0345503116 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Internal Medicine CurrentSince Sep 27, 2018 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince May 22, 2023 Accepting new patients
Bronx Medical Practice P.C. Internal Medicine CurrentSince Mar 1, 2018 Accepting new patients
Essen Medical Associates, PC CurrentSince Mar 1, 2018 Accepting new patients
Essen Medical Associates, PC CurrentSince Mar 1, 2018 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Internal Medicine CurrentSince May 22, 2023 Accepting new patients

Locations

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

26 Research Way
East Setauket, NY 11733
Phone (631) 444-0502

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

300 Community Dr
Manhasset, NY 11030

701 N Broadway
Sleepy Hollow, NY 10591
Phone (914) 366-3140

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: rvalluru66469@northwell.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1341273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526083200000",
    "number": "1689938763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3720 77TH ST APT 2F",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113726630",
            "telephone_number": "646-421-0537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 77TH ST APT 2F",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "11372",
            "telephone_number": "646-421-0537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLURU",
        "first_name": "RAHUL",
        "middle_name": "RAJA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-03",
        "last_updated": "2018-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "291911",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "291911",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson Heights, NY

Sources for this page

Verify at the official NPI Registry.