DR. PRAVEEN B. RAJU MD PHD
NPI 1477710069
Psychiatry & Neurology - Neurology with Special Qualifications in Child Neurology in San Diego, CA
About Dr. Praveen B. Raju Md Phd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. PRAVEEN B. RAJU MD PHD (NPI 1477710069) is an individual neurology with special qualifications in child neurology provider in San Diego, California, licensed in California (C194532) and active in the NPI registry since May 2008. He is enrolled in Medicare PECOS and maintains a secondary practice location in New York.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Praveen B. Raju Md Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
3Medicare enrollment records show Praveen Raju reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
San Diego, CA 92123
- Reassigned Medicare billing, California enrollment
- 562 clinicians in this Medicare group
New York, NY 10013
- Reassigned Medicare billing, New York enrollment
- Medicare enrollment name: Weill Medical College Of Cornell
- 980 clinicians in this Medicare group
New York, NY 10021
- Reassigned Medicare billing, New York enrollment
- 220 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 92123 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
SAN DIEGO, CA 92123
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 Praveen Raju's NPI number?
The NPI number for Praveen Raju is 1477710069. It was assigned to this individual provider in the NPPES registry on May 21, 2008.
Where is Praveen Raju located?
Praveen Raju practices at 3030 Childrens Way, San Diego, CA 92123. The listed phone number is (858) 966-5819.
What is Praveen Raju's specialty?
The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology with Special Qualifications in Child Neurology, with taxonomy code 2084N0402X.
Is Praveen Raju enrolled in Medicare?
Yes. Praveen Raju is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Praveen Raju's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Praveen Raju reassigns Medicare benefits to 3 organizations: Rady Children's Hospital San Diego (San Diego, CA), Weill Medical College Of Cornell University (New York, NY) and Memorial Pediatric Group (New York, NY). Each 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 Praveen Raju's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Praveen Raju was last updated on March 11, 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.
# Dr. Praveen B. Raju, MD PHD · NPI 1477710069
Neurology with Special Qualifications in Child Neurology physician in San Diego, California. Individual provider, active in the CMS NPPES registry since May 21, 2008.
## Identity
- **NPI:** 1477710069 (Entity type: Individual)
- **Enumerated:** May 21, 2008
- **Primary specialty:** Psychiatry & Neurology - Neurology with Special Qualifications in Child Neurology · taxonomy 2084N0402X
- **State license:** C194532 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 3030 CHILDRENS WAY, San Diego, CA 92123-4232
- **Phone:** (858) 966-5819
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Rady Children's Hospital San Diego (NPI 1669617197, San Diego, CA); Weill Medical College Of Cornell University (NPI 1801188313, New York, NY); Memorial Pediatric Group (NPI 1750352381, New York, NY) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 11, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1477710069) · Data from the CMS NPPES public registry.