Raja Barakat, MD
Individual provider Active NPI Pediatric Adolescent Medicine Physician · Holmdel, NJ
NPI 1174586341 · NPPES record last updated Nov 22, 2011
Key facts
- NPI
- 1174586341
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Adolescent Medicine Physician 2080A0000X
- License
- 25MA03700400 (NJ)
- Practice address
- 733 N Beers St
Suite L5
Holmdel, NJ 07733-1528 - Phone
- (732) 739-2100
- Fax
- (732) 739-1002
- NPI assigned
- Apr 10, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160804000275 | NJ | Order and Referring Only - Pediatric Medicine |
1456363514 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Peter'S University Hospital | Past | Accepting new patients | |
| HMH Hospitals Corporation | Past | Accepting new patients | |
| The Samra Group, LLC | Adolescent Medicine | Past | Accepting new patients |
| HMH Hospitals Corporation | Past | Accepting new patients | |
| Samra Plastic and Reconstructive Surgery LLC | Past | Accepting new patients | |
| Robert Wood Johnson University Hospital, Inc | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/8568/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | 25MA03700400 | NJ | Yes |
Addresses
Primary practice location
733 N Beers St
Suite L5
Holmdel, NJ 07733-1528
Mailing address
733 N Beers St
Suite L5
Holmdel, NJ 07733-1528
Phone (732) 739-2100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 315501 | Medicaid | NJ |
Other providers in Holmdel, NJ
- Christa L Ayers
- Ayoub Pediatrics PA
- Samia B Ayoub
- Basil J Baccash
- Denise Balacich
- Ganna Bartasheva
- Quinn Mariette Batcho
- Thomas Edward Baumlin Jr.
- Bay Shore Marriage and Family Consultants
- Bayshore Acupuncture & Traditional Medicine
All providers in Holmdel, NJ · Pediatric Adolescent Medicine Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 22, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.