Active NPI
Melanie Rajkumar, M.D.
- Emergency Medicine Physician
- Mason City, IA
National Provider Identifier
1962847434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- MD477565
- Practice address
- 101 S Taylor Ave
Mason City, IA 50401-2849 - Phone
- (641) 428-7766
- Fax
- (641) 428-7788
- NPI assigned
- May 9, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | MD477565 | PA | Primary |
| Family Medicine Physician | 207Q00000X | R-9626 | IA | |
| Emergency Medicine Physician | 207P00000X | 01078213 | IN |
Addresses
Primary practice location
101 S Taylor Ave
Mason City, IA 50401-2849
Mailing address
3926 New Vision Dr
Fort Wayne, IN 46845-1712
Phone (260) 266-8210
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104042217-0001 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220517003271 | PA | Practitioner - Emergency Medicine | 0749419034 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01078213 | IN | MD | Emergency Medicine Physician |
| MD477565 | PA | MD | Emergency Medicine Physician |
| R-9626 | IA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Physician Associates of Pennsylvania, PC | Emergency Medicine | Current | Accepting new patients |
Locations
307 S Evergreen Ave
Woodbury, NJ 08096
Phone (856) 686-4300
206 E Brown St
East Stroudsburg, PA 18301
Phone (570) 420-4951
300 Highland Ave
Hanover, PA 17331
Phone (717) 316-3711
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.
-
- Emergency Medicine Physician
- Hanover, PA
- NPI 1619990900
Emergency Medicine, PA
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1368057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701648000000",
"number": "1962847434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3926 NEW VISION DR",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451712",
"telephone_number": "260-266-8210",
"fax_number": "260-458-5636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 S TAYLOR AVE",
"city": "MASON CITY",
"state": "IA",
"postal_code": "504012849",
"telephone_number": "641-428-7766",
"fax_number": "641-428-7788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAJKUMAR",
"first_name": "MELANIE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-09",
"last_updated": "2023-12-04",
"certification_date": "2023-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "PA",
"license": "MD477565",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "R-9626",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IN",
"license": "01078213",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104042217-0001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mason City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; 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.