Individual provider Active NPI

Raj Gondalia, M.D.

  • Vascular & Interventional Radiology Physician
  • Raleigh, NC
National Provider Identifier
1962761007
Registry record updated Apr 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
2016-02194 Issued in NC
Practice address
3949 Browning PL
Raleigh, NC 27609-6536
Phone
(919) 787-7411
NPI assigned
May 10, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 2016-02194 NC Primary

Addresses

Primary practice location

3949 Browning PL
Raleigh, NC 27609-6536

Mailing address

3949 Browning PL
Raleigh, NC 27609-6536
Phone (919) 787-7411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20180403002739 NC Practitioner - Interventional Radiology 0446512438 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
Duke University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Radiology Consultants PAGroup PAC ID 4385537992, 59 clinicians
Wake Radiology Diagnostic Imaging Inc.Group PAC ID 5092611863, 66 clinicians

Practice addresses (Care Compare)

3949 Browning PL
Raleigh, NC 27609-6535

3949 Browning PL
Raleigh, NC 27609-6536
Phone (919) 787-7411

Hospital & facility affiliations

  • Rex Hospital Hospital, Raleigh, NC, CCN 340114
  • Johnston Health Hospital, Smithfield, NC, CCN 340090
  • Unc Rockingham Hospital, Eden, NC, CCN 340060

Merit-based Incentive Payment System (MIPS)

Final score
94.8 of 100Reported as group
Quality
99.47
Improvement activities
40
Cost
83.62

Merit-based Incentive Payment System (MIPS)

Final score
85.29 of 100Reported as group
Quality
82.69
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016-02194NCMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Radiology Diagnostic Imaging Inc. Vascular & Interventional Radiology CurrentSince May 1, 2018 Accepting new patients
Wake Radiology Consultants PA Vascular & Interventional Radiology CurrentSince May 1, 2018 Accepting new patients

Locations

3949 Browning Pl
Raleigh, NC 27609
Phone (919) 787-8221

Interoperability endpoints

  • Direct secure messaging: rgondalia348929@direct.unc.nchie.net

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1336608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524787200000",
    "number": "1962761007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3949 BROWNING PL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096536",
            "telephone_number": "919-787-7411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3949 BROWNING PL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096536",
            "telephone_number": "919-787-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONDALIA",
        "first_name": "RAJ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-10",
        "last_updated": "2018-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NC",
            "license": "2016-02194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.