Active NPI
Ralph D Raphael, PH.D.
- Psychologist
- Baltimore, MD
National Provider Identifier
1144316175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1705
- Practice address
- 21 West Rd
Suite 150
Baltimore, MD 21204-2325 - Phone
- (410) 825-0042
- Fax
- (410) 825-0310
- NPI assigned
- Oct 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1705 | MD | Primary |
Addresses
Primary practice location
21 West Rd
Suite 150
Baltimore, MD 21204-2325
Mailing address
21 West Rd
Suite 150
Baltimore, MD 21204-2325
Phone (410) 825-0042
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: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2019 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1705 | MD | MD | Psychologist |
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": "1183852800000",
"number": "1144316175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 WEST RD",
"address_2": "SUITE 150",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212042325",
"telephone_number": "410-825-0042",
"fax_number": "410-825-0310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 WEST RD",
"address_2": "SUITE 150",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212042325",
"telephone_number": "410-825-0042",
"fax_number": "410-825-0310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAPHAEL",
"first_name": "RALPH",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MD",
"license": "1705",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.