Individual provider Active NPI

Nisha Raja-Rahman, M.D.

  • Occupational Medicine Physician
  • Springfield, IL
National Provider Identifier
1821319260
Registry record updated Dec 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
036136824 Issued in IL
Practice address
775 Engineering Ave
Springfield, IL 62703-5909
Phone
(217) 528-7541
NPI assigned
Jun 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Physician 2083X0100X 036136824 IL Primary

Addresses

Primary practice location

775 Engineering Ave
Springfield, IL 62703-5909

Mailing address

1025 S 6TH St
Springfield, IL 62703-2403
Phone (217) 528-7541

Other names 1

  • Nisha R Ramamoorthy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20190422000238 TX Practitioner - Physical Medicine and Rehabilitation 9739421868 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036136824ILMDOccupational Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care, P.a. Current Accepting new patients
American Current Care, P.a. CurrentSince Mar 19, 2019 Accepting new patients
American Current Care P.a. CurrentSince Mar 19, 2019 Accepting new patients

Locations

15810 Midway Rd
Addison, TX 75001
Phone (972) 458-8111

4025 Spid Dr
Corpus Christi, TX 78411
Phone (361) 852-8255

1002 Abc Ave
Ste 600
Freeport, TX 77541
Phone (979) 233-6571

12345 Katy Fwy
Houston, TX 77079
Phone (281) 679-5600

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.

NPI Registry JSON

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

{
    "created_epoch": "1277078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450742400000",
    "number": "1821319260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032403",
            "telephone_number": "217-528-7541",
            "fax_number": "217-528-8962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 ENGINEERING AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627035909",
            "telephone_number": "217-528-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJA-RAHMAN",
        "first_name": "NISHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-21",
        "last_updated": "2015-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "IL",
            "license": "036136824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NISHA",
            "last_name": "RAMAMOORTHY",
            "middle_name": "R",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.