NPIMap

Individual provider Active NPI

Raju B Raval, DO

  • Internal Medicine Physician
  • Fayetteville, NC
National Provider Identifier
1962403196
Registry record updated Feb 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9700722 Issued in NC
Practice address
9525 Cliffdale Road
Fayetteville, NC 28304-5956
Phone
(910) 826-7828
Fax
(910) 864-7925
NPI assigned
Aug 10, 2005
Last updated
Feb 4, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9700722 NC Primary

Addresses

Primary practice location

9525 Cliffdale Road
Fayetteville, NC 28304-5956

Mailing address

PO Box 87707
Fayetteville, NC 28304-5956
Phone (910) 826-7828

Other identifiers 3

IdentifierTypeStateIssuer
5903128MedicaidNC
1110GOtherNCBCBS GROUP # 015CK
027AUOtherNCBCBS

Other names 1

  • Raju B Raval Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040812000486 NC Practitioner - Internal Medicine 9032181631 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9525 Cliffdale Rd
Fayetteville, NC 28304-5956
Phone (910) 826-7828

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9700722NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Statcare,LLC Internal Medicine Current Accepting new patients
CFV Express Care Billing Services LLC CurrentSince Oct 1, 2006 Accepting new patients
Cumberland County Hospital System Inc Internal Medicine CurrentSince Sep 4, 2007 Accepting new patients
Statcare, LLC Internal Medicine CurrentSince Aug 6, 2009 Accepting new patients
Cumberland County Hospital System Inc Current Accepting new patients
Cumberland County Hospital System Inc CurrentSince Sep 4, 2007 Accepting new patients
Hoke Healthcare, LLC Past Accepting new patients
Laurinburg Radiology Associates PA PastSince Jan 1, 2001 Accepting new patients

Locations

150 Robeson St
Fayetteville, NC 28301
Phone (910) 609-1000

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

524 Beaumont Rd
Fayetteville, NC 28304
Phone (910) 609-3879

6387 Ramsey St
Unit 100
Fayetteville, NC 28311
Phone (910) 615-3879

9525 Cliffdale Rd
Fayetteville, NC 28304
Phone (910) 221-0300

300 Medical Pavilion Dr
#25
Raeford, NC 28376
Phone (910) 904-8035

Interoperability endpoints

  • Direct secure messaging: statcareurgentcareclinic.rajuraval@118764.advancedmd-direct.com

Organizations & group practices 8

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 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1962403196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 87707",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283045956",
            "telephone_number": "910-826-7828",
            "fax_number": "910-864-7925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9525 CLIFFDALE ROAD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283045956",
            "telephone_number": "910-826-7828",
            "fax_number": "910-864-7925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVAL",
        "first_name": "RAJU",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "9700722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5903128",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP # 015CK",
            "identifier": "1110G",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "027AU",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAJU",
            "last_name": "RAVAL",
            "middle_name": "B",
            "credential": "D.O.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.