Individual provider Active NPI

Pooja Raghavan, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Winston Salem, NC
National Provider Identifier
1801026810
Registry record updated Oct 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
2016-01930 Issued in NC
Practice address
755 Highland Oaks Dr
Ste 201
Winston Salem, NC 27103-7106
Phone
(336) 765-0020
Fax
(336) 765-0581
NPI assigned
Jul 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 2016-01930 NC Primary

Addresses

Primary practice location

755 Highland Oaks Dr
Ste 201
Winston Salem, NC 27103-7106

Mailing address

PO Box 751803
Charlotte, NC 28275-1803
Phone (336) 765-0020

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address praghaven404211@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20161128001561 NC Practitioner - EndocrinologyPractitioner - Internal Medicine 6103008115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Forsyth Memorial Hospital IncGroup PAC ID 9537071790, 622 clinicians

Practice addresses (Care Compare)

755 Highland Oaks Dr
Suite 201
Winston Salem, NC 27103-7106
Phone (336) 765-0020

Hospital & facility affiliations

  • Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Forsyth Memorial Hospital, Inc. Endocrinology, Diabetes & Metabolism CurrentSince Oct 1, 2016 Accepting new patients
Forsyth Memorial Hospital, Inc. Current Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Oct 1, 2016 Accepting new patients

Locations

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

291 Broad St
Kernersville, NC 27284
Phone (336) 993-8181

903 Randolph St
Ste 1
Thomasville, NC 27360
Phone (336) 475-7163

903 Randolph St
Thomasville, NC 27360
Phone (336) 475-7163

755 Highland Oaks Dr
Ste 201
Winston Salem, NC 27103
Phone (336) 765-0020

Interoperability endpoints

  • Direct secure messaging: praghaven404211@direct.novanthealth.org

Organizations & group practices 3

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": "1248393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1801026810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803",
            "telephone_number": "336-765-0020",
            "fax_number": "336-765-0581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 HIGHLAND OAKS DR",
            "address_2": "STE 201",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271037106",
            "telephone_number": "336-765-0020",
            "fax_number": "336-765-0581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGHAVAN",
        "first_name": "POOJA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-24",
        "last_updated": "2020-10-25",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NC",
            "license": "2016-01930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "praghaven404211@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "755 Highland Oaks Dr",
            "address_2": "Ste 201",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271037106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.