Active NPI
Rawan Badran, MD
- Internal Medicine Physician
- Staten Island, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 331805-01
- Practice address
- 475 Seaview Ave
Staten Island, NY 10305-3436 - Phone
- (718) 226-9000
- NPI assigned
- Apr 6, 2021
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 331805-01 | NY | Primary |
Addresses
Primary practice location
475 Seaview Ave
Staten Island, NY 10305-3436
Mailing address
475 Seaview Ave
Staten Island, NY 10305-3436
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 |
|---|---|---|---|---|
| I20241121001513 | NY | Practitioner - Hospitalist | 7416482971 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 331805-01 | NY | MD | Internal Medicine Physician |
Practice roles (2 of 6)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore-Lij Medical PC | Internal Medicine | Current | Accepting new patients |
| Staten Island University Hospital | Past | Accepting new patients |
Locations
1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650
300 Community Dr
Plandome, NY 11030
475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
Interoperability endpoints
- rbadran66021@northwell.direct-ci.com
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- Staten Island, NY
- NPI 1407877137
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Staten Island, NY
- NPI 1407877137
Hospital
Care Compare profile
Medicare Care Compare- Specialty
- Hospitalist
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- North Shore-Lij Medical PC
Practice addresses (Care Compare)
475 Seaview Ave
Staten Island, NY 10305-3436
Phone (212) 434-6980
Hospital & facility affiliations
- Staten Island University Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730073600000",
"number": "1114506136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "475 SEAVIEW AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103053436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "475 SEAVIEW AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103053436",
"telephone_number": "718-226-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BADRAN",
"first_name": "RAWAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-06",
"last_updated": "2024-10-28",
"certification_date": "2024-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "331805-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.