Individual provider Active NPI

Raghav Rastogi, MD

  • Internal Medicine Physician
  • Glen Ridge, NJ
National Provider Identifier
1780985267
Registry record updated Apr 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA09390800 Issued in NJ
Practice address
123 Highland Ave
Glen Ridge, NJ 07028-1527
Phone
(973) 748-0678
Fax
(973) 748-2808
NPI assigned
Nov 15, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2017

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 267161 NY
Internal Medicine Physician 207R00000X 25MA09390800 NJ Primary

Addresses

Primary practice location

123 Highland Ave
Glen Ridge, NJ 07028-1527

Mailing address

PO Box 419430
Boston, MA 02241-9430
Phone (201) 666-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20140210001238 NJ Practitioner - Internal Medicine 8123257375 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MPV New Jersey MD Services PCGroup PAC ID 5991097669, 146 clinicians

Practice addresses (Care Compare)

1 Bay Ave
Montclair, NJ 07042-4837
Phone (201) 781-1387

311 Bay Ave
Glen Ridge, NJ 07028-1607
Phone (973) 748-9246

622 Franklin Ave
Nutley, NJ 07110-1247
Phone (973) 661-1900

Hospital & facility affiliations

  • Atlantic Visiting Nurse Home health agency, Morristown, NJ, CCN 317054
  • Bayada Home Health Care, Inc Home health agency, Livingston, NJ, CCN 317021
  • Patient Care Home health agency, West Orange, NJ, CCN 317060
  • Hackensack Meridian Mountainside Medical Hospital, Montclair, NJ, CCN 310054

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09390800NJMDInternal Medicine Physician
267161NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montclair Hospital LLC CurrentSince May 1, 2014 Accepting new patients
Montclair Hospital LLC Internal Medicine CurrentSince May 1, 2014 Accepting new patients
MPV New Jersey MD Services PC CurrentSince Aug 1, 2016 Accepting new patients
MPV New Jersey MD Services PC CurrentSince Aug 1, 2016 Accepting new patients

Locations

452 Old Hook Rd
Fl 2
Emerson, NJ 07630
Phone (201) 599-1336

311 Bay Ave
Glen Ridge, NJ 07028
Phone (973) 748-9166

123 Highland Ave
Glen Ridge, NJ 07028
Phone (973) 746-7474

123 Highland Ave
Ste 201
Glen Ridge, NJ 07028
Phone (862) 333-4700

1 Bay Ave
Montclair, NJ 07042
Phone (973) 429-6100

Interoperability endpoints

  • Direct secure messaging: rrastogi191463@ahs.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1289779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493251200000",
    "number": "1780985267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419430",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022419430",
            "telephone_number": "201-666-3900",
            "fax_number": "201-261-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 HIGHLAND AVE",
            "city": "GLEN RIDGE",
            "state": "NJ",
            "postal_code": "070281527",
            "telephone_number": "973-748-0678",
            "fax_number": "973-748-2808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASTOGI",
        "first_name": "RAGHAV",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-15",
        "last_updated": "2017-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "267161",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA09390800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Ridge, NJ

Sources for this page

Verify at the official NPI Registry.