Individual provider Active NPI

Rajiv Devanagondi, M.D.

  • Pediatric Cardiology Physician
  • Iowa City, IA
National Provider Identifier
1710143383
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
MD-53980 Issued in IA
Practice address
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone
(319) 356-2229
Fax
(319) 384-6955
NPI assigned
Aug 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Congenital Heart Disease Physician 207RA0002X MD-53980 IA
Pediatric Cardiology Physician 2080P0202X 280364 NY
Pediatric Cardiology Physician 2080P0202X 280364-1 NY
Pediatric Cardiology Physician 2080P0202X MD-53980 IA Primary

Addresses

Primary practice location

200 Hawkins Dr
Iowa City, IA 52242-1009

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-2229

Other practice location 1

1236 E Rusholme St Ste 100
Davenport, IA 52803-2473
Phone (319) 356-2229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, IA2 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
I20160125000537 NY Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 0749407708 Reassigns benefits to 4 organizations
I20250109002383 IA Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 0749407708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Cardiovascular Disease (Cardiology), Interventional Cardiology
Education
Johns Hopkins University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State University of IowaGroup PAC ID 7618884230, 1,886 clinicians

Practice addresses (Care Compare)

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-1616

Hospital & facility affiliations

  • University of Iowa Hospital & Clinics Hospital, Iowa City, IA, CCN 160058

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
280364NYMDPediatric Cardiology Physician
280364-1NYMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Frederick Ferris Thompson Hospital CurrentSince Jan 11, 2023 Accepting new patients
The Frederick Ferris Thompson Hospital CurrentSince Jan 11, 2023 Accepting new patients
The Memorial Hospital of William F. and Gertrude F. Jones, Inc. CurrentSince Jul 5, 2024 Accepting new patients
State University of Iowa CurrentSince Dec 27, 2024 Accepting new patients
St James Hospital CurrentSince Sep 28, 2024 Accepting new patients
Pediatric Cardiology Pediatric Cardiology CurrentSince Nov 18, 2015 Accepting new patients
The Memorial Hospital of William F. and Gertrude F. Jones, Inc. CurrentSince Jul 5, 2024 Accepting new patients
State University of Iowa Past Accepting new patients
State University of Iowa Past Accepting new patients

Locations

1236 E Rusholme St
Ste 100
Davenport, IA 52803
Phone (563) 421-3980

200 Hawkins Dr
#H
Iowa City, IA 52242
Phone (319) 356-1616

200 Hawkins Dr
Iowa City, IA 52242
Phone (319) 356-1616

73 Buffalo St
Ste 100
Canandaigua, NY 14424

7309 Seneca Rd N
Ste 108
Hornell, NY 14843
Phone (607) 385-3790

7329 Seneca Rd N
North Hornell, NY 14843
Phone (607) 247-2200

601 Elmwood Ave
#631
Rochester, NY 14642
Phone (585) 275-2808

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

15 Canandaigua St
Shortsville, NY 14548
Phone (585) 289-3560

191 N Main St
Wellsville, NY 14895
Phone (585) 593-1100

Organizations & group practices 9

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 1

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": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1710143383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-2229",
            "fax_number": "319-384-6955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-2229",
            "fax_number": "319-384-6955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1236 E Rusholme St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Davenport",
            "state": "IA",
            "postal_code": "528032473",
            "country_code": "US",
            "telephone_number": "319-356-2229",
            "fax_number": "319-384-6955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEVANAGONDI",
        "first_name": "RAJIV",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-04",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adult Congenital Heart Disease",
            "state": "IA",
            "license": "MD-53980",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NY",
            "license": "280364",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NY",
            "license": "280364-1",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "IA",
            "license": "MD-53980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.