MEDICARE: DR. RAJNISH BANSAL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD10218	RI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	110193084	OTHER	RI	RAILROAD MEDICARE
8	709004159	OTHER	RI	MEDICARE GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10240	OTHER	RI	NEIGHBORHOOD HEALTH PLAN
2	406635	OTHER	RI	BLUE CHIP
3	04-02810	OTHER	RI	UNITED HEALTH CARE
4	0540483739	OTHER	RI	GREAT WEST HEALTH CARE
6	710046201	OTHER	RI	CIGNA
7	69821	OTHER	RI	HARVARD HEALTH PLAN
9	22011	OTHER	RI	BCBS OF RI
10	402478	OTHER	RI	TUFTS HEALTH PLAN
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417944190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAJNISH BANSAL MD

Provider Business Mailing Address
First Line	:	10 DAVOL SQ
Second Line	:	STE 400
City	:	PROVIDENCE
State	:	RI
Zip	:	02903-4754
Country	:	US
Telephone Number	:	401-421-4000
Fax Number	:	401-272-1456

Provider Business Practice Location Address
First Line	:	900 WARREN AVE
Second Line	:	STE 400
City	:	EAST PROVIDENCE
State	:	RI
Zip	:	02914-1430
Country	:	US
Telephone Number	:	401-331-1221
Fax Number	:	401-751-8003

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2005
Last Update Date	:	04/02/2024

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