Individual provider Active NPI

John Joachim Rawlings, MD

  • Internal Medicine Physician
  • Bayside, NY
National Provider Identifier
1023114568
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
116163 Issued in NY
Practice address
4402 Francis Lewis Blvd
Suite a
Bayside, NY 11361-3041
Phone
(718) 631-0500
Fax
(718) 281-1276
NPI assigned
Sep 15, 2006
Last updated
Mar 22, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 116163 NY Primary

Addresses

Primary practice location

4402 Francis Lewis Blvd
Suite a
Bayside, NY 11361-3041

Mailing address

135 Augusta Dr
Medford
Medford, NY 11763-2401
Phone (516) 551-0219

Other identifiers 1

IdentifierTypeStateIssuer
00279263MedicaidNY

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170619002862 NY Order and Referring Only - Geriatric MedicinePractitioner - Geriatric Medicine 1456361708

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
116163NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peter R Barra MD John J Rawlings MD John C Coman MD LLP Internal Medicine Current Accepting new patients

Locations

4402 Francis Lewis Blvd
Bayside, NY 11361
Phone (718) 631-0500

4402 Francis Lewis Blvd
Ste A
Bayside, NY 11361
Phone (718) 631-0500

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1023114568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 AUGUSTA DR",
            "address_2": "MEDFORD",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632401",
            "telephone_number": "516-551-0219",
            "fax_number": "631-683-4651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4402 FRANCIS LEWIS BLVD",
            "address_2": "SUITE A",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613041",
            "telephone_number": "718-631-0500",
            "fax_number": "718-281-1276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAWLINGS",
        "first_name": "JOHN",
        "middle_name": "JOACHIM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "116163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00279263",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

Verify at the official NPI Registry.