Individual provider Active NPI

Erela Katz Rappaport, D.M.D.

  • General Practice Dentistry
  • Poway, CA
National Provider Identifier
1073609277
Registry record updated Aug 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
40187 Issued in CA
Practice address
15706 Pomerado Rd
Suite 205
Poway, CA 92064-2067
Phone
(858) 726-5554
Fax
(858) 487-4281
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 40187 CA Primary

Addresses

Primary practice location

15706 Pomerado Rd
Suite 205
Poway, CA 92064-2067

Mailing address

15706 Pomerado Rd
Suite 205
Poway, CA 92064-2067
Phone (858) 726-5554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
40187CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Erela Katz Rappaport DMD a Professional Corporation General Practice CurrentSince Aug 28, 2022 Accepting new patients

Locations

15706 Pomerado Rd
Ste 205
Poway, CA 92064
Phone (858) 674-5954

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1073609277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15706 POMERADO RD",
            "address_2": "SUITE 205",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642067",
            "telephone_number": "858-726-5554",
            "fax_number": "858-487-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15706 POMERADO RD",
            "address_2": "SUITE 205",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642067",
            "telephone_number": "858-726-5554",
            "fax_number": "858-487-4281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAPPAPORT",
        "first_name": "ERELA",
        "middle_name": "KATZ",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "40187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poway, CA

Sources for this page

Verify at the official NPI Registry.