KARAN RAI MD
NPI 1306343603
Family Medicine - Sports Medicine in Bloomington, IL

Q: What is Karan Rai's NPI number?

The NPI number for Karan Rai is 1306343603. It was assigned to this individual provider in the NPPES registry on April 12, 2018.

Q: What is Karan Rai's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Q: When was this NPI record last updated?

The NPPES record for Karan Rai was last updated on March 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 12, 2018PECOS EnrolledAccepts Medicare Assignment

1701 E COLLEGE AVE, BLOOMINGTON, IL 61704(309) 664-3000 Get Directions Write a Review

NPPES record last updated: March 10, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 10, 2025, Aug 16, 2022, Aug 2, 2018 and 1 more (4 updates tracked since 2018).

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About Karan Rai Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KARAN RAI MD (NPI 1306343603) is an individual sports medicine provider in Bloomington, Illinois, licensed in Illinois (336.119768) and active in the NPI registry since April 2018. He is enrolled in Medicare PECOS, is affiliated with Saint James Hospital, and maintains a secondary practice location in O Fallon.

NPPES Registry Identity

NPI1306343603

Entity TypeIndividualMale

Primary Taxonomy207QS0010X

Provider Legal NameKARAN RAICredential: MD

Location Address1701 E COLLEGE AVEBloomington, IL 61704-2100

Mailing Address2509 Keystone RdBloomington, IL 61704-8439 · (602) 489-9800

Phone(309) 664-3000

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateApril 12, 2018

Last NPPES UpdateMarch 10, 20254 updates tracked since enumeration

NPPES CertifiedMarch 10, 2025

✔ NPI 1306343603 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QS0010X

License✔ Licensed in IL · 336.119768

Definition

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

Also ListedFamily MedicineTaxonomy 207Q00000X · License 125.072854 (IL)

1701 E COLLEGE AVE, Bloomington, IL 61704

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Secondary Practice Location 1

Location 13 Saint Elizabeth Blvd Ste 4000O Fallon, IL 62269 · Phone (618) 233-5480 · Fax (618) 222-4792

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Karan Rai Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1254681950

PECOS Enrollment IDI20220819001626

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg J7325

Synvisc or Synvisc-One is a treatment involving an injection of a substance called hyaluronan into your joints. This substance, naturally found in the body, helps lubricate and cushion your joints, reducing pain and improving mobility. It's often used for arthritis patients.

880 services12 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

560 services91 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

85 services57 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

74 services74 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

72 services58 patients

Aspiration and/or injection of fluid large joint using ultrasound guidance 20611

This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.

57 services39 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Saint James Hospital

Acute Care Hospitals · Pontiac, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140161

Location2500 West Reynolds StreetPontiac, IL 61764 · Livingston County

Birthing friendly

St Joseph Medical Center

Acute Care Hospitals · Bloomington, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140162

Location2200 E WashingtonBloomington, IL 61701 · Mc Lean County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61704 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. MARY CLAIRE BILES PT, MDT

Physical Therapist