Heraganahally Nagegowda Sundar Raj, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

MD 4121 Issued in NV

Practice address

1221 N Decatur Blvd
Ste 5
Las Vegas, NV 89108-2497

Phone

(702) 785-3005

NPI assigned

Mar 8, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• H.N. Sundar Raj Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Saint Mary'S Medical Group Inc

  • Community/Retail Pharmacy
  • Reno, NV
  • NPI 1447635578
  NPD
• Saint Marys Medical Group Inc.

  • Primary Care Clinic/Center
  • Reno, NV
  • NPI 1538424239
  NPD
• Saint Marys Urgent Care LLC

  • Multi-Specialty Clinic/Center
  • Reno, NV
  • NPI 1275898975
  NPD

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

{
    "created_epoch": "1299542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1922306497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6255 SHARLANDS AVE",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895232882",
            "telephone_number": "775-770-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 N DECATUR BLVD",
            "address_2": "STE 5",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891082497",
            "telephone_number": "702-785-3005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDAR RAJ",
        "first_name": "HERAGANAHALLY",
        "middle_name": "NAGEGOWDA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-08",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "4121",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NV",
            "license": "4121",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NV",
            "license": "MD 4121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "H.N.",
            "last_name": "SUNDAR RAJ",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Song Sun
• Yaoyun Sun
• Sunarch LLC
• Sunbright Medical Center LLC
• Sundance Medical Center LLP
• Sunday Eve Elderly Care LLC
• Kristy Marie Sundell
• Richard Michael Sundstrom
• Hyeran Sung Yoon, RPH
• Eun Ae Sung

• General Practice Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• General Practice Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.