Individual provider Active NPI

Bharat Raju, M.D.

  • Family Medicine Physician
  • Dayton, OH
National Provider Identifier
1720217581
Registry record updated May 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.099710 Issued in OH
Practice address
2345 Philadelphia Dr
Dayton, OH 45406-1816
Phone
(937) 276-4141
NPI assigned
Jul 14, 2009
Last updated
May 2, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35.099710 OH Primary

Addresses

Primary practice location

2345 Philadelphia Dr
Dayton, OH 45406-1816

Mailing address

7702 Oak Ridge CT
Crystal Lake, IL 60012-1600
Phone (815) 404-9628

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20150910000175 IL Practitioner - Family Practice 9830346477 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CGH Medical CenterGroup PAC ID 6103723267, 199 clinicians

Practice addresses (Care Compare)

100 E Le Fevre Rd
Sterling, IL 61081-1278
Phone (815) 625-0400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.099710OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mendota Community Hospital CurrentSince Nov 1, 2020 Accepting new patients
Mendota Community Hospital Family Medicine Current Accepting new patients
CGH Medical Center CurrentSince Sep 1, 2015 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
CGH Medical Center CurrentSince Sep 1, 2015 Accepting new patients
Osf Multi-Specialty Group CurrentSince Sep 1, 2021 Accepting new patients
Mendota Community Hospital CurrentSince Nov 1, 2020 Accepting new patients
Sidney Emergency Physicians, Inc. Past Accepting new patients
Middletown Emergency Physicians, Inc. Past Accepting new patients

Locations

1404 Washington St
Mendota, IL 61342
Phone (815) 538-1825

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

600 E 1st St
Spring Valley, IL 61362
Phone (815) 664-1477

100 E Lefevre Rd
Sterling, IL 61081
Phone (815) 625-0400

1809 Locust St
Sterling, IL 61081
Phone (815) 564-4002

Interoperability endpoints

  • Direct secure messaging: braju19551@cghmc.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367452800000",
    "number": "1720217581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7702 OAK RIDGE CT",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600121600",
            "telephone_number": "815-404-9628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 PHILADELPHIA DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454061816",
            "telephone_number": "937-276-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJU",
        "first_name": "BHARAT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-14",
        "last_updated": "2013-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.099710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.