Rafael Z Axen, MD

Key facts

NPI

1124069216

Entity type

Individual (NPI type 1)

Primary specialty

Anesthesiology Physician 207L00000X

License

227630 (NY)

Practice address

34 South Bedford Road
Mt. Kisco, NY 10549

Phone

(914) 244-6789

Fax

(914) 242-1516

NPI assigned

Jun 9, 2006

Sex

Male

Sole proprietor

No

Organizations & group practices 3

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.

• Optum Medical Care, P.C. Cardiovascular Disease Physician · Mount Kisco, NY · NPI 1982643003
  Medicare reassignment Care Compare group NPD NY
• Optum Medical Care, P.C. Durable Medical Equipment & Medical Supplies · New Hyde Park, NY · NPI 1053190595
  NPD
• Endoscopy Center of Western New York LLC Ambulatory Surgical Clinic/Center · Williamsville, NY · NPI 1063419513
  NPD (past)

Medicare Care Compare profile

Specialty

Anesthesiology

Education

Rutgers New Jersey Medical School, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optum Medical Care PC (1,013 clinicians)

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles (3 of 7)

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 23, 2016.

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1124069216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 SOUTH BEDFORD ROAD",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493412",
            "telephone_number": "914-244-6789",
            "fax_number": "914-242-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 SOUTH BEDFORD ROAD",
            "city": "MT. KISCO",
            "state": "NY",
            "postal_code": "10549",
            "telephone_number": "914-244-6789",
            "fax_number": "914-242-1516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AXEN",
        "first_name": "RAFAEL",
        "middle_name": "Z",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "227630",
            "primary": true
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "NY",
            "license": "227630",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "227630",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE RAILROAD",
            "identifier": "DB5589",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Joan A Austin, RN BSC
• Michael Andrew Avaricio, MD
• Alphonse Aversa, MD
• Charles D. Azzaretti, D.D.S.
• Sateesh Babu, MD
• Back to Health PT LLC
• Max Abraham Bader, DNP
• Barry Baer, MD

All providers in Mt. Kisco, NY · Anesthesiology Physician in New York