Organization Active NPI

Rajiv Kumar MD Inc

  • Psychiatry Physician
  • Agoura Hills, CA
National Provider Identifier
1801024252
Registry record updated Jun 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
RAJIV KUMAR MD INC
Practice address
30423 Canwood St Ste 118
Agoura Hills, CA 91301-4314
Phone
(425) 802-2861
NPI assigned
Jun 24, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2009

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

Authorized official

Name
Ms. Rebecca Lyn Peterson
Title
Business Manager
Phone
(425) 802-2861

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

30423 Canwood St Ste 118
Agoura Hills, CA 91301-4314

Mailing address

30423 Canwood St Ste 118
Agoura Hills, CA 91301-4314
Phone (425) 802-2861

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120507000563 CA Part B Supplier - Clinic/Group Practice 3779745831 Receives reassigned benefits from 1 practitioner
Practice locations: Agoura Hills, CA

National Provider Directory

National Provider Directory

Locations

30423 Canwood St
Ste 118
Agoura Hills, CA 91301
Phone (425) 802-2861

30423 Canwood St
Ste 140
Agoura Hills, CA 91301
Phone (818) 707-2130

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245801600000",
    "number": "1801024252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30423 CANWOOD ST STE 118",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913014314",
            "telephone_number": "425-802-2861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30423 CANWOOD ST STE 118",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913014314",
            "telephone_number": "425-802-2861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAJIV KUMAR MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-24",
        "last_updated": "2009-06-24",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "LYN",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "425-802-2861",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Agoura Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.