NPIMap

Individual provider Active NPI

Raja Hassan Imtiaz, MD

  • Interventional Pain Medicine Physician
  • Batesville, AR
National Provider Identifier
1861054181
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
E17096 Issued in AR
Practice address
1700 Harrison St Ste T
Batesville, AR 72501-7315
Phone
(870) 262-6155
Fax
(870) 262-6512
NPI assigned
Jul 8, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Psychiatry & Neurology) Physician 2084P2900X E-17096 AR
Interventional Pain Medicine Physician 208VP0014X E17096 AR Primary

Addresses

Primary practice location

1700 Harrison St Ste T
Batesville, AR 72501-7315

Mailing address

1710 Harrison St
Batesville, AR 72501-7303
Phone (870) 262-6155

Other identifiers 1

IdentifierTypeStateIssuer
321206001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240611002772 AR Practitioner - Pain Management 6901348507 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
White River Health System, Inc.Group PAC ID 0143134270, 190 clinicians

Practice addresses (Care Compare)

108 N Shackeford Rd
Little Rock, AR 72211-2840

1700 Harrison St
Suite T
Batesville, AR 72501-7315
Phone (870) 262-6155

1710 Harrison St
Batesville, AR 72501-7303

195 Hospital Dr
Suite 27
Cherokee Village, AR 72529-7314
Phone (870) 262-6155

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-17096ARMDPain Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
White River Health System, Inc. Interventional Pain Medicine CurrentSince Jul 1, 2024 Accepting new patients
White River Health System, Inc. Interventional Pain Medicine CurrentSince Jul 1, 2024 Accepting new patients
Pain Treatment Centers of America, PLLC Interventional Pain Medicine CurrentSince Aug 1, 2024 Accepting new patients
Michael S. Clarke, M.D., P.a. Current Accepting new patients
Pain Treatment Centers of America PLLC CurrentSince Aug 1, 2024 Accepting new patients
North Arkansas Regional Medical Center CurrentSince Jun 1, 2025 Accepting new patients
North Arkansas Regional Medical Center CurrentSince Jun 1, 2025 Accepting new patients
North Arkansas Regional Medical Center Current Accepting new patients
Pain Treatment Centers of America, PLLC Past Accepting new patients

Locations

1710 Harrison St
Batesville, AR 72501
Phone (870) 262-1240

1215 Sidney St
Batesville, AR 72501
Phone (870) 262-1541

1700 Harrison St
Ste T
Batesville, AR 72501
Phone (870) 262-3280

620 N Main St
Ste 2B
Harrison, AR 72601
Phone (870) 414-4000

4318 Highway 65 S
Harrison, AR 72601
Phone (870) 414-4040

4020 Richards Rd
Ste A
North Little Rock, AR 72117
Phone (501) 900-8763

Interoperability endpoints

  • Direct secure messaging: raja.imtiaz@4330.securemail.prognocis.com

Organizations & group practices 9

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 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1861054181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 HARRISON ST",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725017303",
            "telephone_number": "870-262-6155",
            "fax_number": "870-262-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 HARRISON ST STE T",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725017315",
            "telephone_number": "870-262-6155",
            "fax_number": "870-262-6512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMTIAZ",
        "first_name": "RAJA HASSAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-08",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": "AR",
            "license": "E-17096",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "AR",
            "license": "E17096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "321206001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Batesville, AR

Sources for this page

Verify at the official NPI Registry.