Surendran Raja Raja Varma, M.D.

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

043632 Issued in CT

Practice address

625 Clark Ave
Bristol, CT 06010-4068

Phone

(860) 583-7700

Fax

(860) 589-7656

NPI assigned

Jul 27, 2005

Last updated

May 2, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Internal Medicine

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Prohealth Physicians PCGroup PAC ID 1355246950, 214 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bristol Hospital Home Care Agency Home health agency, Bristol, CT, CCN 077198
• Hartford Healthcare at Home Home health agency, East Hartford, CT, CCN 077041
• Bristol Home Care and Hospice Agency, Inc. Hospice, Bristol, CT, CCN 071517
• Bristol Hospital Hospital, Bristol, CT, CCN 070029

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: surendran.varma.npi1891795316.phpct@direct.optumcare.masshiway.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Prohealth Physicians PC

  • Family Medicine Physician
  • Farmington, CT
  • NPI 1720194053

  Internal Medicine

  Medicare reassignment Care Compare group NPD

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

• Bristol Home Care and Hospice Agency Inc

  • Home Health Agency
  • Bristol, CT
  • NPI 1811092273
  Care Compare affiliation
• Bristol Home Care and Hospice Agency Inc

  • Community Based Hospice Care Agency
  • Bristol, CT
  • NPI 1922120534
  Care Compare affiliation
• Bristol Hospital Incorporated

  • General Acute Care Hospital
  • Bristol, CT
  • NPI 1619901642
  Care Compare affiliation
• Hartford Healthcare at Home, Inc

  • Home Health Agency
  • Wethersfield, CT
  • NPI 1073529566
  Care Compare affiliation

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1891795316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 CLARK AVE",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060104068",
            "telephone_number": "860-583-7700",
            "fax_number": "860-589-7656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 CLARK AVE",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060104068",
            "telephone_number": "860-583-7700",
            "fax_number": "860-589-7656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARMA",
        "first_name": "SURENDRAN",
        "middle_name": "RAJA RAJA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-27",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "232460",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CT",
            "license": "043632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02592556",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891795316",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Usacs of Connecticut, LLC
• Favor Okwuchukwu Uwaya
• Jitesh Vachhani, M.D.
• Jessica J Vanderfeen, AU.D., CCC-A
• Sai Varanasi, M.D.
• Jaimie Vassiliou
• Rita Vaszily, MD
• Vein Centers, LLC
• Kamakshi Vemareddy, MD
• Vicky Tompkins LMFT LLC

• Geriatric Medicine (Internal Medicine) Physician in Bristol, CT
• Providers in Bristol, CT by specialty
• Geriatric Medicine (Internal Medicine) Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.