Individual provider Active NPI

Douglas Jay Raskin, M.D., D.M.D.

  • Plastic Surgery Physician
  • Colorado Springs, CO
National Provider Identifier
1053376152
Registry record updated Oct 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
25809 Issued in CO
Practice address
559 E Pikes Peak Ave
#209
Colorado Springs, CO 80903-3651
Phone
(719) 578-9988
Fax
(719) 578-9976
NPI assigned
Apr 20, 2006
Last updated
Oct 15, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 25809 CO Primary

Addresses

Primary practice location

559 E Pikes Peak Ave
#209
Colorado Springs, CO 80903-3651

Mailing address

559 E Pikes Peak Ave
#209
Colorado Springs, CO 80903-3651
Phone (719) 578-9988

Other identifiers 1

IdentifierTypeStateIssuer
01258094MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25809COMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Larry D. Dillon, M.D., P.C. Past Accepting new patients

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": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192406400000",
    "number": "1053376152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 E PIKES PEAK AVE",
            "address_2": "#209",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809033651",
            "telephone_number": "719-578-9988",
            "fax_number": "719-578-9976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "559 E PIKES PEAK AVE",
            "address_2": "#209",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809033651",
            "telephone_number": "719-578-9988",
            "fax_number": "719-578-9976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASKIN",
        "first_name": "DOUGLAS",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "M.D., D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2007-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CO",
            "license": "25809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01258094",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.