Dr Rajesh Kannan Ethiraj, MD, is a medicare enrolled "Preventive Medicine - Occupational Medicine" physician in Quincy, Illinois. His current practice location is
927 Broadway St, Quincy, Illinois. You can reach out to his office (for appointments etc.) via phone at
(217) 223-6423.
Dr Rajesh Kannan Ethiraj is licensed to practice in Illinois (license number 036121632) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1669667242.
Physician's Profile
| Full Name | Dr Rajesh Kannan Ethiraj |
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| Gender | Male |
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| Speciality | Preventive Medicine - Occupational Medicine |
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| Location | 927 Broadway St, Quincy, Illinois |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1669667242
- Provider Enumeration Date: 09/07/2007
- Last Update Date: 07/03/2024
Medicare PECOS Information:
- PECOS PAC ID: 4082878590
- Enrollment ID: I20120613000672
Medical Identifiers
Medical identifiers for Dr Rajesh Kannan Ethiraj such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1669667242 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2083P0500X | Preventive Medicine - Preventive Medicine/occupational Environmental Medicine | U0017 (Texas) | Secondary |
| 2083X0100X | Preventive Medicine - Occupational Medicine | 56255 (Wisconsin) | Secondary |
| 2083X0100X | Preventive Medicine - Occupational Medicine | 036121632 (Illinois) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Rajesh Kannan Ethiraj allows following entities to bill medicare on his behalf.
| Entity Name | Blessing Corporate Services Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1851311641
PECOS PAC ID: 5991616138
Enrollment ID: O20050222000479 |
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| Entity Name | Blessing Hospital |
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| Entity Type | Part B Supplier - Hospital Department(s) |
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| Entity Identifiers | NPI Number: 1114471737
PECOS PAC ID: 3072422534
Enrollment ID: O20161005001836 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Rajesh Kannan Ethiraj is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Rajesh Kannan Ethiraj, MD,
1005 Broadway St,
Quincy, IL 62301-2834
Ph: (217) 223-8400 | Dr Rajesh Kannan Ethiraj, MD,
927 Broadway St,
Quincy, IL 62301-2719
Ph: (217) 223-6423 |
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