Active NPI
Miriam Rachel Raport, D.O.
- Geriatric Medicine (Internal Medicine) Physician
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- License
- 215452
- Practice address
- 36 7TH Ave
Suite 416
New York, NY 10011-6609 - Phone
- (212) 243-7522
- Fax
- (646) 486-4681
- NPI assigned
- Jul 5, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | 215452 | NY | Primary |
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | 61945 | NJ |
Addresses
Primary practice location
36 7TH Ave
Suite 416
New York, NY 10011-6609
Mailing address
36 7TH Ave
Suite 416
New York, NY 10011-6609
Phone (212) 243-7522
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 61945 | Other | NJ | LICENSE |
| 02364583 | Medicaid | NY | |
| 215452 | Other | NY | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61945 | NJ | MD | Geriatric Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore-Lij Medical PC | Current | Accepting new patients | |
| Bimc Faculty Practice | Past | Accepting new patients | |
| St Vincents Hospital and Medical Center | Past | Accepting new patients | |
| Bimc Faculty Practice | Past | Accepting new patients |
Locations
30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066
1554 Northern Blvd
Manhasset, NY 11030
Phone (516) 390-9242
300 Community Dr
Manhasset, NY 11030
10 Union Sq E
New York, NY 10003
Phone (212) 253-6800
10 Union Sq E
#3
New York, NY 10003
Phone (212) 420-4145
972 Brush Hollow Rd
Westbury, NY 11590
Organizations & group practices 4
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013948777",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36 7TH AVE",
"address_2": "SUITE 416",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100116609",
"telephone_number": "212-243-7522",
"fax_number": "646-486-4681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36 7TH AVE",
"address_2": "SUITE 416",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100116609",
"telephone_number": "212-243-7522",
"fax_number": "646-486-4681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAPORT",
"first_name": "MIRIAM",
"middle_name": "RACHEL",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "NY",
"license": "215452",
"primary": true
},
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "NJ",
"license": "61945",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "61945",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02364583",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "215452",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.