NPIMap

Individual provider Active NPI

Raymond Lee Holsten, MD

  • Family Medicine Physician
  • Page, AZ
National Provider Identifier
1003810540
Registry record updated Dec 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
21867 Issued in AZ
Practice address
467 Vista Avenue
Page, AZ 86040-1625
Phone
(928) 645-8123
Fax
(928) 645-3862
NPI assigned
Jun 13, 2005
Last updated
Dec 10, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 21867 AZ Primary

Addresses

Primary practice location

467 Vista Avenue
Page, AZ 86040-1625

Mailing address

PO Box 1625
Page, AZ 86040-1625
Phone (928) 645-8123

Other identifiers 1

IdentifierTypeStateIssuer
145989MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040308001097 AZ Practitioner - Family PracticePractitioner - Geriatric Medicine 8224926662 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
University of Southern California Keck School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

440 N Navajo Dr
Page, AZ 86040-1625
Phone (928) 645-1700

467 Vista Ave
Page, AZ 86040-1478
Phone (928) 645-8123

501 N Navajo
Page, AZ 86040
Phone (928) 645-2424

PO Box
Suite 1625
Page, AZ 86040-1625

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.7 of 100Reported as group
Quality
64.97
Promoting interoperability
98
Improvement activities
40
Cost
69.88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Hospital Based Physicians Arizona LLC Current Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Sep 1, 2012 Accepting new patients
Canyonlands Community Health Care CurrentSince Jul 1, 2000 Accepting new patients
Page Hospital Current Accepting new patients
Canyonlands Community Health Care Family Medicine Current Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Sep 1, 2012 Accepting new patients
Canyonlands Community Health Care Family Medicine CurrentSince Jul 1, 2000 Accepting new patients
Canyonlands Community Health Care Past Accepting new patients
Canyonlands Community Health Care Past Accepting new patients

Locations

10 Ward Canyon Rd
#A
Clifton, AZ 85533
Phone (928) 645-9675

5860 S Hospital Dr
Ste 102
Globe, AZ 85501
Phone (928) 402-0491

3272 E Rio Virgin Rd
Littlefield, AZ 86432
Phone (928) 347-5971

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

1615 S 1st Ave
Safford, AZ 85546
Phone (928) 348-1701

2016 W 16th St
Safford, AZ 85546
Phone (520) 428-1377

Interoperability endpoints

  • Direct secure messaging: raymond.holsten.p1@direct.canyonlands.nextgenshare.com

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291939200000",
    "number": "1003810540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1625",
            "city": "PAGE",
            "state": "AZ",
            "postal_code": "860401625",
            "telephone_number": "928-645-8123",
            "fax_number": "928-645-3862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "467 VISTA AVENUE",
            "city": "PAGE",
            "state": "AZ",
            "postal_code": "860401625",
            "telephone_number": "928-645-8123",
            "fax_number": "928-645-3862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLSTEN",
        "first_name": "RAYMOND",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2010-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "21867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145989",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Page, AZ

Sources for this page

Verify at the official NPI Registry.