Individual provider Active NPI

Raul Jose Masakayan, M.D.

  • Anesthesiology Physician
  • Setauket, NY
National Provider Identifier
1194706614
Registry record updated Nov 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
211412 Issued in NY
Practice address
32 Setalcott PL
Setauket, NY 11733-1326
Phone
(631) 246-9276
NPI assigned
Nov 10, 2005
Last updated
Nov 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 211412 NY Primary

Addresses

Primary practice location

32 Setalcott PL
Setauket, NY 11733-1326

Mailing address

32 Setalcott PL
Setauket, NY 11733-1326
Phone (631) 848-3155

Other identifiers 2

IdentifierTypeStateIssuer
9C3011OtherNYEMPIRE BLUECROSS BLUESHIE
01883696MedicaidNY

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
I20050405000588 NY Practitioner - Anesthesiology 4486601150 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Island Gastroenterology Consultants PCGroup PAC ID 8921999079, 13 clinicians
East Coast Gastroenterology and Endoscopy PCGroup PAC ID 3274889662, 3 clinicians

Practice addresses (Care Compare)

1111 Montauk Hwy
Suite 3
West Islip, NY 11795-4910
Phone (631) 669-1171

153 N Ocean Ave
Patchogue, NY 11772-2018
Phone (631) 714-4444

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
King-Chen Hon Office Based Endoscopy PLLC CurrentSince Nov 1, 2022 Accepting new patients
Northeast Endoscopy LLC Anesthesiology CurrentSince Jul 30, 2023 Accepting new patients
Island Gastroenterology Consultants PC Specialist CurrentSince Feb 1, 2013 Accepting new patients
New Day Medical PC Anesthesiology CurrentSince Sep 20, 2022 Accepting new patients
East Coast Gastroenterology and Endoscopy PC CurrentSince Nov 26, 2023 Accepting new patients
Queens Boulevard ASC LLC CurrentSince Jul 1, 2022 Accepting new patients
Ae&Ly Ambulatory Endoscopy PLLC CurrentSince Aug 1, 2022 Accepting new patients
Goldstep Ambulatory Surgery Center, LLC Anesthesiology CurrentSince Apr 10, 2023 Accepting new patients
Gold Coast Medical P C Anesthesiology CurrentSince Aug 23, 2022 Accepting new patients
Robert Bernholc MD PC Anesthesiology Past Accepting new patients

Locations

200 Broadway
Ste 3116
Brooklyn, NY 11211

3007 Farragut Rd
Brooklyn, NY 11210
Phone (347) 915-1177

35 Spencer St
Ste 200
Brooklyn, NY 11205

13511 40th Rd
Ste 3A
Flushing, NY 11354
Phone (646) 417-0641

13602 Roosevelt Ave
Flushing, NY 11354
Phone (718) 886-3212

13633 37th Ave
#7
Flushing, NY 11354

13633 37th Ave
Fl 7
Flushing, NY 11354
Phone (718) 321-3262

4161 Kissena Blvd
Ste D
Flushing, NY 11355
Phone (718) 359-2827

1880 E Jericho Tpke
Huntington, NY 11743
Phone (631) 629-4628

40 E 10th St
Ste 1W
New York, NY 10003
Phone (212) 344-9524

153 N Ocean Ave
Patchogue, NY 11772
Phone (631) 714-4444

9525 Queens Blvd
Rego Park, NY 11374
Phone (718) 286-1000

9525 Queens Blvd
Frnt 3
Rego Park, NY 11374
Phone (718) 406-8000

235 N Belle Mead Rd
Setauket, NY 11733
Phone (631) 450-1200

237 Jericho Tpke
Syosset, NY 11791
Phone (516) 584-6400

1111 Montauk Hwy
#3
West Islip, NY 11795
Phone (631) 669-1171

1111 Montauk Hwy
Ste 3
West Islip, NY 11795
Phone (631) 669-1171

1175 Montauk Hwy
Ste 3
West Islip, NY 11795
Phone (631) 433-1159

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668124800000",
    "number": "1194706614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 SETALCOTT PL",
            "city": "SETAUKET",
            "state": "NY",
            "postal_code": "117331326",
            "telephone_number": "631-848-3155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 SETALCOTT PL",
            "city": "SETAUKET",
            "state": "NY",
            "postal_code": "117331326",
            "telephone_number": "631-246-9276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASAKAYAN",
        "first_name": "RAUL",
        "middle_name": "JOSE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "211412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUECROSS BLUESHIE",
            "identifier": "9C3011",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01883696",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Setauket, NY

Sources for this page

Verify at the official NPI Registry.