Individual provider Active NPI

Raja Suri, MD

  • Internal Medicine Physician
  • Shreveport, LA
National Provider Identifier
1740867043
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
343561 Issued in LA
Practice address
2600 Greenwood Rd Dept of
Shreveport, LA 71103-3908
Phone
(318) 212-8137
NPI assigned
Mar 24, 2021
Last updated
Jan 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 343561 LA Primary

Addresses

Primary practice location

2600 Greenwood Rd Dept of
Shreveport, LA 71103-3908

Mailing address

42 Peter LN
New Hyde Park, NY 11040-1808
Phone (516) 708-5377

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20250122002468 LA Practitioner - Internal Medicine 0547654857 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coolidge Physician Services LLCGroup PAC ID 7113156035, 52 clinicians

Practice addresses (Care Compare)

1214 Coolidge Blvd
Lafayette, LA 70503-2621
Phone (337) 289-7991

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Louisiana Physicians, LLC Internal Medicine CurrentSince Dec 17, 2024 Accepting new patients
St Martin Physician Services LLC CurrentSince Dec 17, 2024 Accepting new patients
Coolidge Physician Services LLC CurrentSince Dec 17, 2024 Accepting new patients
Lafayette General Medical Center Inc Past Accepting new patients

Locations

2531 Viking Dr
Bossier City, LA 71111
Phone (318) 681-7000

210 Champagne Blvd
Breaux Bridge, LA 70517
Phone (337) 332-2178

1214 Coolidge Blvd
Lafayette, LA 70503
Phone (337) 234-9191

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 681-4138

Organizations & group practices 4

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": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1740867043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 PETER LN",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401808",
            "telephone_number": "516-708-5377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 GREENWOOD RD DEPT OF",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033908",
            "telephone_number": "318-212-8137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURI",
        "first_name": "RAJA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-24",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "343561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.