Individual provider Active NPI

Raymol M Varghese, M.D.

  • Pediatrics Physician
  • Brooklyn, NY
National Provider Identifier
1184666273
Registry record updated Dec 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
146303 Issued in NY
Practice address
760 Broadway
Woodhull Vmedical and Mental Health Center
Brooklyn, NY 11206-5317
Phone
(718) 963-9779
Fax
(718) 963-7957
NPI assigned
Jun 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 146303 NY Primary

Addresses

Primary practice location

760 Broadway
Woodhull Vmedical and Mental Health Center
Brooklyn, NY 11206-5317

Mailing address

35 Whittier Dr
Albertson, NY 11507-1016
Phone (516) 484-0238

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150303000945 NY Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 6406172840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450310400000",
    "number": "1184666273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 WHITTIER DR",
            "city": "ALBERTSON",
            "state": "NY",
            "postal_code": "115071016",
            "telephone_number": "516-484-0238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 BROADWAY",
            "address_2": "WOODHULL VMEDICAL AND MENTAL HEALTH CENTER",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112065317",
            "telephone_number": "718-963-9779",
            "fax_number": "718-963-7957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGHESE",
        "first_name": "RAYMOL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2015-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "146303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.