Individual provider Active NPI

Leela Vadrevu Raju, M.D.

  • Ophthalmology Physician
  • New York, NY
National Provider Identifier
1972705069
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
343287 Issued in LA
Practice address
222 E 41St St
New York, NY 10017-6739
Phone
(718) 834-1976
NPI assigned
Jun 1, 2007
Last updated
Aug 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD438077 PA
Ophthalmology Physician 207W00000X NY277202 NY
Ophthalmology Physician 207W00000X 23808 WV
Ophthalmology Physician 207W00000X 343287 LA Primary

Addresses

Primary practice location

222 E 41St St
New York, NY 10017-6739

Mailing address

222 E 41St St
New York, NY 10017-6739

Other identifiers 1

IdentifierTypeStateIssuer
165836FFFOtherPAMEDICARE PROVIDER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lraju148848@nyumc.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NC, LA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20150402001740 NY Practitioner - Ophthalmology 4789721481 Reassigns benefits to 1 organization
I20240722004042 NC Practitioner - Ophthalmology 4789721481 Reassigns benefits to 1 organization
I20240815004723 LA Practitioner - Ophthalmology 4789721481 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
JC Edwards School of Medicine, Marshall University, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

4200 Houma Blvd
Metairie, LA 70006-2970
Phone (504) 503-4000

9 Medical Dr
Greenville, NC 27834-2805
Phone (252) 816-9700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NY277202NYMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Administrators of the Tulane Educational Fund Current Accepting new patients
Children's Hospital CurrentSince Nov 11, 2024 Accepting new patients
Administrators of the Tulane Educational Fund CurrentSince Aug 1, 2024 Accepting new patients
Administrators of the Tulane Education Fund CurrentSince Aug 1, 2024 Accepting new patients
Vidant Medical Group LLC CurrentSince Jun 25, 2024 Accepting new patients
New York University CurrentSince Dec 1, 2016 Accepting new patients
New York University CurrentSince Dec 1, 2016 Accepting new patients

Locations

95 Judge Tanner Blvd
Covington, LA 70433
Phone (504) 867-3800

4700 S I 10 Svc Rd W
Metairie, LA 70001
Phone (504) 780-6453

4200 Houma Blvd
Metairie, LA 70006
Phone (504) 454-4028

200 Henry Clay Ave
New Orleans, LA 70118
Phone (504) 412-1860

3100 General Degaulle Dr
New Orleans, LA 70114
Phone (504) 535-2945

1415 Tulane Ave
New Orleans, LA 70112
Phone (504) 588-2300

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

149 Pierrepont St
Brooklyn, NY 11201
Phone (718) 815-6222

550 1st Ave
New York, NY 10016
Phone (212) 263-3293

222 E 41st St
New York, NY 10017
Phone (212) 263-2573

1200 South Ave
Ste 204
Staten Island, NY 10314
Phone (718) 494-9055

Interoperability endpoints

  • Direct secure messaging: lraju681353@nychhc.direct-ci.com
  • Direct secure messaging: lraju148848@nyumc.direct-ci.com

Organizations & group practices 7

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 8

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": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1972705069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 E 41ST ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 E 41ST ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176739",
            "telephone_number": "718-834-1976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJU",
        "first_name": "LEELA",
        "middle_name": "VADREVU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-01",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD438077",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "NY277202",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WV",
            "license": "23808",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "LA",
            "license": "343287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER",
            "identifier": "165836FFF",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lraju148848@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "222 E 41st St",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100176739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.