Active NPI
Gwen Baron Raphan, M.D.
- Pediatrics Physician
- New York, NY
National Provider Identifier
1053442582
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 234228
- Practice address
- 1 Gustave L Levy PL
Box 1512
New York, NY 10029-6500 - Phone
- (212) 241-1852
- NPI assigned
- Mar 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 234228 | NY | Primary |
Addresses
Primary practice location
1 Gustave L Levy PL
Box 1512
New York, NY 10029-6500
Mailing address
1245 Park Ave Apt 17C
New York, NY 10128-1740
Phone (212) 722-6619
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240228003989 | NY | Order and Referring Only - Pediatric Medicine | 0941393078 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 234228 | NY | MD | Pediatrics Physician |
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053442582",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1245 PARK AVE APT 17C",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101281740",
"telephone_number": "212-722-6619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 GUSTAVE L LEVY PL",
"address_2": "BOX 1512",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100296500",
"telephone_number": "212-241-1852"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAPHAN",
"first_name": "GWEN",
"middle_name": "BARON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "234228",
"primary": true
}
],
"identifiers": [],
"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.