Individual provider Active NPI

Santosh Raja, DO

  • General Practice Physician
  • O'Fallon, IL
National Provider Identifier
1881191187
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
2179 Issued in NE
Practice address
3 Saint Elizabeth Blvd Ste 4000
O Fallon, IL 62269-1284
Phone
(618) 233-7880
Fax
(618) 256-6558
NPI assigned
Apr 12, 2018
Last updated
Sep 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 2179 NE Primary

Addresses

Primary practice location

3 Saint Elizabeth Blvd Ste 4000
O Fallon, IL 62269-1284

Mailing address

3 Saint Elizabeth Blvd Ste 4000
O Fallon, IL 62269-1284
Phone (618) 233-7880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20200424001032 OH Order and Referring Only - General PracticePractitioner - General Practice 2860822376

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2179NEMDGeneral Practice Physician

Interoperability endpoints

  • Direct secure messaging: santosh.raja.1@9559.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1881191187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SAINT ELIZABETH BLVD STE 4000",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691284",
            "telephone_number": "618-233-7880",
            "fax_number": "618-256-6558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SAINT ELIZABETH BLVD STE 4000",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691284",
            "telephone_number": "618-233-7880",
            "fax_number": "618-256-6558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJA",
        "first_name": "SANTOSH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-12",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NE",
            "license": "2179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O'Fallon, IL

Sources for this page

Verify at the official NPI Registry.