Individual provider Active NPI

Bernard Raskin, MD

  • Dermatology Physician
  • Valencia, CA
National Provider Identifier
1013941962
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
G34720 Issued in CA
Practice address
28212 Kelly Johnson Pkwy Ste 245
Valencia, CA 91355-5092
Phone
(661) 254-3686
Fax
(661) 254-5671
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X G34720 CA Primary

Addresses

Primary practice location

28212 Kelly Johnson Pkwy Ste 245
Valencia, CA 91355-5092

Mailing address

28212 Kelly Johnson Pkwy
Ste 245
Valencia, CA 91355-5092
Phone (661) 254-3686

Other identifiers 2

IdentifierTypeStateIssuer
00G347200MedicaidCA
1013941962OtherCANPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110526000751 CA Practitioner - DermatologyPractitioner - Internal Medicine 0749194819 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Internal Medicine
Education
University of California, Irvine, California College of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

28212 Kelly Johnson Pkwy
Suite 245
Valencia, CA 91355-5092
Phone (661) 254-3686

Merit-based Incentive Payment System (MIPS)

Final score
97.5 of 100Reported as individual
Quality
95
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision19
Removal of tissue1-10
Removal of skin lesions854
Removal of skin cancer22
Removal or shaving of skin growth1-10
Skin biopsy262

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G34720CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Dermatology & Cosmetics Laser Care a Medical Corporation Dermatology CurrentSince Feb 17, 2002 Accepting new patients
The Regents of the University of California Dermatology CurrentSince Jul 1, 2017 Accepting new patients
The Regents of the University of California CurrentSince Jul 1, 2017 Accepting new patients
The Regents of the University of California CurrentSince Jul 1, 2017 Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Henry Mayo Newhall Memorial Hospital Past Accepting new patients

Locations

4100 Empire Dr
Ste 120
Bakersfield, CA 93309
Phone (661) 254-3686

200 Medical Plz
Ste 465
Los Angeles, CA 90095
Phone (310) 825-5510

200 Medical Plz
Ste 450
Los Angeles, CA 90095
Phone (310) 825-6751

File 55737
Los Angeles, CA 90074

655 W Avenue Q
Ste B
Palmdale, CA 93551
Phone (661) 228-0680

19950 Rinaldi St
Ste 101D
Porter Ranch, CA 91326
Phone (818) 488-5188

19709 Rinaldi St
Ste 101D
Porter Ranch, CA 91326

19709 Rinaldi St
Porter Ranch, CA 91326
Phone (661) 254-3686

2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381

100 Moody Ct
Ste 110
Thousand Oaks, CA 91360
Phone (805) 418-3500

28212 Kelly Johnson Pkwy
Ste 245
Valencia, CA 91355
Phone (661) 254-3686

28212 Kelly Johnson Pkwy
Ste 265
Valencia, CA 91355
Phone (661) 254-3686

23861 McBean Pkwy
Ste E21
Valencia, CA 91355
Phone (626) 900-8875

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1013941962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28212 KELLY JOHNSON PKWY",
            "address_2": "STE 245",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913555092",
            "telephone_number": "661-254-3686",
            "fax_number": "661-254-5671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28212 KELLY JOHNSON PKWY STE 245",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913555092",
            "telephone_number": "661-254-3686",
            "fax_number": "661-254-5671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASKIN",
        "first_name": "BERNARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G34720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G347200",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1013941962",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

Verify at the official NPI Registry.