MR. PRAJAY RATHORE M.D
NPI 1417410887
Internal Medicine in Danbury, CT

Q: What is Prajay Rathore's NPI number?

The NPI number for Prajay Rathore is 1417410887. It was assigned to this individual provider in the NPPES registry on April 11, 2019.

Q: What is Prajay Rathore's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Prajay Rathore was last updated on January 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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 11, 2019PECOS Enrolled

70 MAIN ST, DANBURY, CT 06810(203) 743-0100 Get Directions Write a Review

NPPES record last updated: January 18, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 3, 2024, Sep 22, 2022, Jul 5, 2019 and 1 more (4 updates tracked since 2019).

On this page

About Mr. Prajay Rathore M.d NPPES

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

MR. PRAJAY RATHORE M.D (NPI 1417410887) is an individual internal medicine provider in Danbury, Connecticut, licensed in Connecticut (75662) and active in the NPI registry since April 2019. He is enrolled in Medicare PECOS, maintains a secondary practice location in Fitchburg, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1417410887

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameMR. PRAJAY RATHORECredential: M.D

Location Address70 MAIN STDanbury, CT 06810-7832

Mailing AddressPo Box 415348Boston, MA 02241-5348 · (800) 222-5088 · Fax (083) 341-9775

Phone(203) 743-0100

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateApril 11, 2019

Last NPPES UpdateJanuary 18, 20244 updates tracked since enumeration

NPPES CertifiedJanuary 18, 2024

✔ NPI 1417410887 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Licenses✔ Licensed in CT · 75662✔ Licensed in MA · 291275

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

70 MAIN ST, Danbury, CT 06810

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Secondary Practice Location 1

Location 1370 Lunenburg StFitchburg, MA 01420-4541 · Phone (978) 342-6018

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Prajay Rathore M.d is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4789915505

PECOS Enrollment IDI20240301002250

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.

Medicare Billing Reassignment

Medicare enrollment records show Prajay Rathore reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Optimus Health Care Inc

19 mi

Federally Qualified Health Center (FQHC)

82 GEORGE ST
Bridgeport, CT 06604

Reassigned Medicare billing, Connecticut enrollment
132 clinicians in this Medicare group

NPI 1215207782 (203) 579-3881

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 2

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.

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.

20 services20 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06810 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

$138.84 typical visit price

range $60.82 – $183.10

Typical copayment $34.71 (range $15.20 – $45.77)

Most-billed visit code 99204

Established Patient

$106.68 typical visit price

range $19.76 – $149.26

Typical copayment $26.67 (range $4.94 – $37.31)

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.

DANBURY HOSPITAL

Clinic/Center (Dental)

70 MAIN ST
DANBURY, CT 06810

Western Connecticut Planning Region (203) 791-5010

JILLIAN BERNSTEIN

Student in an Organized Health Care Education/Training Program

70 MAIN ST
DANBURY, CT 06810

Western Connecticut Planning Region (203) 739-8100

VERONICA IVETTE RON MD

Pediatrics

70 MAIN ST
DANBURY, CT 06810

Western Connecticut Planning Region (203) 791-5020

DR. MELISSA WHITNEY RODGERS DMD

Dentist (General Practice)

70 MAIN ST
DANBURY, CT 06810

Western Connecticut Planning Region (203) 798-8840

DR. BANYA MYO WIN MD

Internal Medicine

70 MAIN ST
DANBURY, CT 06810

Western Connecticut Planning Region (203) 456-1405

DR. THOMAS JOSEPH KAHL DDS

Dentist (General Practice)

70 MAIN ST
DANBURY, CT 06810

Western Connecticut Planning Region (203) 791-5010

DR. MASOOMA BHATTI D.M.D

Student in an Organized Health Care Education/Training Program

70 MAIN ST, DANBURY HOSPITAL, DENTAL CLINIC
DANBURY, CT 06810

Western Connecticut Planning Region (203) 791-5010

CONNECTICUT INSTITUTE FOR COMMUNITIES INC

Clinic/Center (Federally Qualified Health Center (FQHC))

70 MAIN ST
DANBURY, CT 06810

Western Connecticut Planning Region (203) 743-0100

DR. ANNA ADAMS KIMBERLY DMD

Student in an Organized Health Care Education/Training Program

70 MAIN ST
DANBURY, CT 06810

Western Connecticut Planning Region (203) 791-5010

DR. HILARIE WILSON GALLOWAY DMD

Student in an Organized Health Care Education/Training Program

70 MAIN ST
DANBURY, CT 06810

Western Connecticut Planning Region (203) 791-5015

CONNECTICUT INSTITUTE FOR COMMUNITIES INC

Clinic/Center (Federally Qualified Health Center (FQHC))

70 MAIN ST
DANBURY, CT 06810

Western Connecticut Planning Region (203) 743-0100

EMILY MAHEALANI RUNDLETT

Student in an Organized Health Care Education/Training Program

70 MAIN ST
DANBURY, CT 06810

Western Connecticut Planning Region (203) 739-8100

CASSANDRA HALPIN

Student in an Organized Health Care Education/Training Program

70 MAIN ST
DANBURY, CT 06810

Western Connecticut Planning Region (203) 739-8100

JOHN CHARLES ZYZO DMD

Dentist (General Practice)

70 MAIN ST
DANBURY, CT 06810

Western Connecticut Planning Region (203) 739-8100

SAMANTHA SHEPPARD DMD

Student in an Organized Health Care Education/Training Program

70 MAIN ST
DANBURY, CT 06810

Western Connecticut Planning Region (203) 739-6612

DAVID MITCHELL ZOLOV MD

Internal Medicine (Allergy & Immunology)

70 MAIN ST
DANBURY, CT 06810

Western Connecticut Planning Region (203) 743-0100

SUZANNE M ALLEN DMD

Student in an Organized Health Care Education/Training Program

70 MAIN ST
DANBURY, CT 06810

Western Connecticut Planning Region (203) 739-6612

THOMAS MICHAEL PERKINS

Student in an Organized Health Care Education/Training Program

70 MAIN ST
DANBURY, CT 06810

Western Connecticut Planning Region (203) 233-7492

HEIDI DUPRET ROWEN M.D.

Obstetrics & Gynecology

70 MAIN ST
DANBURY, CT 06810

Western Connecticut Planning Region (203) 743-0100

DR. ANN FRANCES RUVOLO DMD

Student in an Organized Health Care Education/Training Program

70 MAIN ST
DANBURY, CT 06810

Western Connecticut Planning Region (203) 739-6612

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Prajay Rathore's NPI number?

The NPI number for Prajay Rathore is 1417410887. It was assigned to this individual provider in the NPPES registry on April 11, 2019.

Where is Prajay Rathore located?

Prajay Rathore practices at 70 Main St, Danbury, CT 06810. The listed phone number is (203) 743-0100.

What is Prajay Rathore's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Prajay Rathore enrolled in Medicare?

Yes. Prajay Rathore is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Prajay Rathore's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Prajay Rathore reassigns Medicare benefits to Optimus Health Care Inc (Bridgeport, CT). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Prajay Rathore's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Prajay Rathore accept?

Health plans from Anthem Blue Cross and Blue Shield list Prajay Rathore as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Prajay Rathore was last updated on January 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.