Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Raghu Idupuganti, DO

Individual provider Anesthesiology Physician · NPI 1124051065

Raghu Idupuganti, DO is an Anesthesiology in Mineola, New York. Qualified in 2002, 24 years ago. Practices with North Shore - Lij Anesthesiology, PC, a 1,004-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New York.

Years since qualifying
24
Licensed in
NY
In the registry since
2006
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

259 1st St
Mineola, NY 11501-3957
Phone: (516) 663-2216
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4802 10th Ave, Brooklyn, NY 11219-2916 — (718) 283-8816

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence 238871 (NY)

Record details

NPI number1124051065
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJuly 7, 2006
Last updated in NPPESAugust 29, 2022
Certification dateAugust 29, 2022
Mailing address255 W Michigan Ave, Jackson, MI 49201-2218

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice North Shore - Lij Anesthesiology, Pc — 1004 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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