Raphael Mordecai Mizrahi, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

900 23Rd St NW
Washington, DC 20037-2342

Phone

(202) 539-1225

NPI assigned

Sep 1, 2023

Sex

Male

Sole proprietor

Yes

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 DC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Whitman-Walker Clinic, Inc

  • Federally Qualified Health Center (FQHC)
  • Washington, DC
  • NPI 1184616617

  Single Specialty

  Medicare reassignment NPD
• Whitman-Walker Clinic Inc.

  • Community/Retail Pharmacy
  • Washington, DC
  • NPI 1003316316
  NPD

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

{
    "created_epoch": "1693526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1174309520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11235 OAK LEAF DR APT B613",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209011318",
            "telephone_number": "732-261-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 23RD ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200372342",
            "telephone_number": "202-539-1225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZRAHI",
        "first_name": "RAPHAEL",
        "middle_name": "MORDECAI",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-01",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Anye Miyang
• Lauren Miyares, MD
• Agwe Achu Miyeh
• Marisa Mize, CPNP,CPNP-AC
• Tony Carlos Mize
• MJ General, LLC
• MJM Anesthesia ,LLC
• MJM Anesthesia ,LLC
• MJM Anesthesia SP LLC
• Dickson M Mkama

• Physician Assistant in Washington, DC
• Providers in Washington, DC by specialty
• Physician Assistant in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; 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.