Krishnaswamy Gajaraj, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

155544 Issued in MA

Practice address

1093 N Main St
Randolph, MA 02368-2100

Phone

(781) 963-7775

Fax

(781) 963-7776

NPI assigned

Dec 18, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Psychiatry

Education

Other, 1973

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Southeastern Psychiatric AssocGroup PAC ID 4486696614, 15 clinicians

Starr Psychiatric Center IncGroup PAC ID 4385742626, 6 clinicians

CK Wellness PLLCGroup PAC ID 8628579000, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• CK Wellness PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Brockton, MA
  • NPI 1679363097

  Psychiatry

  Medicare reassignment Care Compare group NPD
• Southeastern Psychiatric Assoc

  • Psychiatry Physician
  • Randolph, MA
  • NPI 1891771267
  Medicare reassignment Care Compare group NPD
• Starr Psychiatric Center Inc

  • Psychiatry Physician
  • Brockton, MA
  • NPI 1871687129
  Medicare reassignment Care Compare group
• Hri Hospital, Inc

  • Psychiatric Hospital
  • Brookline, MA
  • NPI 1518938174
  Medicare reassignment NPD
• Brockton Hospital, Inc.

  • General Acute Care Hospital
  • Brockton, MA
  • NPI 1063431286
  NPD (past)
• Nova Psychiatric Service

  • Psychologist
  • Quincy, MA
  • NPI 1598838781
  NPD (past)
• Nova Psychiatric Services, PC

  • Community/Behavioral Health Agency
  • Quincy, MA
  • NPI 1881782522
  NPD (past)

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

{
    "created_epoch": "1134864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348012800000",
    "number": "1962488395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1093 N MAIN ST",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023682100",
            "telephone_number": "781-963-7775",
            "fax_number": "781-963-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1093 N MAIN ST",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023682100",
            "telephone_number": "781-963-7775",
            "fax_number": "781-963-7776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAJARAJ",
        "first_name": "KRISHNASWAMY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-18",
        "last_updated": "2012-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "155544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1200283",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teresa A Fulcher, BSN, RN
• Heather L Fuller-Giurlando, BCABA
• Functional Therapy and Rehab, LLC
• Margery Furman
• Michael Furtado
• Amita Ashish Gandhi, RPH
• Sandra Joan Garber, LCSW
• Seema Garg, PHD
• Kimberly Gargiulo
• Gary B Grundy DC PC

• Psychiatry Physician in Randolph, MA
• Providers in Randolph, MA by specialty
• Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2012; 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.