Individual provider Active NPI

Rajeshwari Kalyanaraman, MBBS

  • Obstetrics & Gynecology Physician
  • Brockton, MA
National Provider Identifier
1912528332
Registry record updated Sep 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
1017737 Issued in MA
Practice address
1300 Belmont St
Brockton, MA 02301-4433
Phone
(508) 580-8682
Fax
(508) 583-2515
NPI assigned
Apr 27, 2020
Last updated
Sep 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Obstetrics & Gynecology Physician 207V00000X 1017737 MA Primary

Addresses

Primary practice location

1300 Belmont St
Brockton, MA 02301-4433

Mailing address

39 Saint Paul St Apt G1
Brookline, MA 02446-6920
Phone (617) 899-0034

Other practice location 1

114 Woodland St
Hartford, CT 06105-1208
Phone (860) 714-4440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20241004000890 MA Practitioner - Obstetrics/Gynecology 4183155823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Signature Healthcare Medical Group IncGroup PAC ID 7719876267, 250 clinicians

Practice addresses (Care Compare)

110 Liberty St
Brockton, MA 02301-5521
Phone (508) 894-0400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Healthcare Medical Group Inc Obstetrics & Gynecology CurrentSince Sep 1, 2024 Accepting new patients
Brockton Hospital, Inc. Past Accepting new patients
Women's Health Affiliates, Inc. Obstetrics & Gynecology PastSince Sep 29, 2024 Accepting new patients

Locations

110 Liberty St
Brockton, MA 02301

1300 Belmont St
Brockton, MA 02301
Phone (508) 580-1020

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726963200000",
    "number": "1912528332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 SAINT PAUL ST APT G1",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024466920",
            "telephone_number": "617-899-0034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 BELMONT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014433",
            "telephone_number": "508-580-8682",
            "fax_number": "508-583-2515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "114 Woodland St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061051208",
            "country_code": "US",
            "telephone_number": "860-714-4440",
            "fax_number": "860-714-8012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALYANARAMAN",
        "first_name": "RAJESHWARI",
        "name_prefix": "Dr.",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-27",
        "last_updated": "2024-09-22",
        "certification_date": "2024-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "1017737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.