Individual provider Active NPI

Pooja Raj

  • Marriage & Family Therapist
  • Brooklyn, NY
National Provider Identifier
1922761279
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
2857 Linden Blvd
Brooklyn, NY 11208-5126
Phone
(718) 235-3100
NPI assigned
Oct 14, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

2857 Linden Blvd
Brooklyn, NY 11208-5126

Mailing address

8322 252ND St
Bellerose, NY 11426-2117
Phone (516) 348-5707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240827003064 NY Practitioner - Marriage and Family Therapist 3678012259 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brightside Medical PCGroup PAC ID 4082089461, 64 clinicians

Practice addresses (Care Compare)

2263 James St
Suite 523
Syracuse, NY 13206-3262
Phone (415) 360-3348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002229NYMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Medical, P.C. CurrentSince Aug 1, 2024 Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1634169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1922761279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8322 252ND ST",
            "city": "BELLEROSE",
            "state": "NY",
            "postal_code": "114262117",
            "telephone_number": "516-348-5707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2857 LINDEN BLVD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112085126",
            "telephone_number": "718-235-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJ",
        "first_name": "POOJA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-14",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.