NPIMap

Individual provider Active NPI

Raj Jain, M.D.

  • Diagnostic Radiology Physician
  • Pueblo, CO
National Provider Identifier
1871506972
Registry record updated Nov 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
49990 Issued in CO
Practice address
1008 Minnequa Ave
Pueblo, CO 81004-3733
Phone
(719) 557-4000
Fax
(970) 342-2093
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 49990 CO Primary

Addresses

Primary practice location

1008 Minnequa Ave
Pueblo, CO 81004-3733

Mailing address

PO Box 7693
Loveland, CO 80537-0693
Phone (970) 663-2742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20110919000058 CO Practitioner - Diagnostic Radiology 7012188329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Rochester School of Medicine and Dentistry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pueblo Radiological Group PC 7 clinicians

Practice addresses (Care Compare)

1008 Minnequa Ave
Pueblo, CO 81004-3733
Phone (719) 560-5592

1804 Oakmoor HTS
Colorado Springs, CO 80906-1171
Phone (719) 584-7410

23500 US Hwy 160
Walsenburg, CO 81089-9524
Phone (719) 738-5000

Hospital & facility affiliations

  • St Mary-Corwin Hospital Hospital, Pueblo, CO, CCN 060012
  • St Thomas More Hospital Hospital, Canon City, CO, CCN 061344
  • Spanish Peaks Regional Health Center Hospital, Walsenburg, CO, CCN 061316
  • Parkview Medical Center, Inc Hospital, Pueblo, CO, CCN 060020

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49990COMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pueblo Radiological Group PC Diagnostic Radiology CurrentSince Jul 30, 2012 Accepting new patients
Pueblo Radiological Group, P.C. Diagnostic Radiology PastSince Nov 8, 2020 Accepting new patients

Locations

3245 E US Highway 50
Unit E
Canon City, CO 81212
Phone (719) 285-2700

933 Sell Ave
Canon City, CO 81212
Phone (719) 275-6433

4112 Outlook Blvd
Ste 255
Pueblo, CO 81008
Phone (719) 253-7640

124 W Pitkin Ave
Pueblo, CO 81004
Phone (719) 542-7891

4112 Outlook Blvd
Ste 96
Pueblo, CO 81008
Phone (719) 562-6200

1020 Lakeview Ave
Pueblo, CO 81004
Phone (719) 557-3145

4112 Outlook Blvd
Ste 37
Pueblo, CO 81008
Phone (719) 562-6254

1008 Minnequa Ave
Pueblo, CO 81004
Phone (719) 557-5656

2035 S Pueblo Blvd
Pueblo, CO 81005
Phone (719) 299-4819

729 E Spaulding Ave
Pueblo West, CO 81007
Phone (719) 285-2735

23500 US Highway 160
Walsenburg, CO 81089
Phone (719) 738-5100

Organizations & group practices 2

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1871506972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7693",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805370693",
            "telephone_number": "970-663-2742",
            "fax_number": "970-342-2093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 MINNEQUA AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043733",
            "telephone_number": "719-557-4000",
            "fax_number": "970-342-2093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIN",
        "first_name": "RAJ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "49990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.