Raghu Mitra, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

119844-1 Issued in NY

Practice address

55 Horizon Dr
Huntington, NY 11743-4436

Phone

(631) 920-8000

NPI assigned

Jul 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Family Service League, Inc.

  • Community/Behavioral Health Agency
  • Huntington, NY
  • NPI 1528093242
  Medicare reassignment NPD

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229299200000",
    "number": "1124049226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 WINCHESTER DR",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "115453203",
            "telephone_number": "516-626-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 HORIZON DR",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117434436",
            "telephone_number": "631-920-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITRA",
        "first_name": "RAGHU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2008-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "119844-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arfa Mirza
• Alison Dee Mishkit, MD
• Anushta Mishra
• Gabriella Mitchell
• Angeliqua Mitra, PSY.D.
• Stephanie Moawad
• Anthony Modica
• Edward Joseph Modica Jr., DO
• Frantz Narhum Moise, MD
• Rose Molfetta, LMSW

• Psychiatry Physician in Huntington, NY
• Providers in Huntington, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2008; 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.

Verify at the official NPI Registry.