Individual provider Active NPI

Melanie Rajkumar, M.D.

  • Emergency Medicine Physician
  • Mason City, IA
National Provider Identifier
1962847434
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD477565 Issued in PA
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

Updated by the provider on Dec 4, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
104042217-0001MedicaidPA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
01078213INMDEmergency Medicine Physician
MD477565PAMDEmergency Medicine Physician
R-9626IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physician Associates of Pennsylvania, PC Emergency Medicine CurrentSince May 18, 2022 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.

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

Verify at the official NPI Registry.