Active NPI
Raymond Dattwyler, MD
- Allergy & Immunology (Internal Medicine) Physician
- Huntington, NY
National Provider Identifier
1285658989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy & Immunology (Internal Medicine) Physician
- License
- 145814
- Practice address
- 325 Park Ave
Huntington, NY 11743-2779 - Phone
- (631) 659-4491
- Fax
- (631) 659-4580
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Allergy & Immunology (Internal Medicine) Physician | 207RA0201X | 145814 | NY | Primary |
Addresses
Primary practice location
325 Park Ave
Huntington, NY 11743-2779
Mailing address
325 Park Ave
Huntington, NY 11743-2779
Phone (631) 659-4491
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000090207 | Other | NY | GHI HMO |
| 00662840 | Medicaid | NY | |
| 145814 | Other | HIP | |
| 4589993 | Other | NY | AETNA PPO |
| P3453285 | Other | OXFORD | |
| 3738401 | Other | NY | AETNA HMO |
| 389284 | Other | NY | MVP |
| 133277785 | Other | TRICARE | |
| 2099746 | Other | NY | GHI PPO |
| DR5814 | Other | ATLANTIS | |
| 3C7116 | Other | NY | HEALTHNET |
| 145814 | Other | NY | HIP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 145814 | NY | MD | Allergy & Immunology (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Research Associates,PC | Allergy & Immunology | Past | Accepting new patients |
| Neurology Associates of Stony Brook, University Faculty Practice Corpo | Past | Accepting new patients | |
| Physician Associates of Nyeei, LLC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Valhalla, NY
- NPI 1801841895
Allergy & Immunology
-
- Neurology Physician
- Stony Brook, NY
- NPI 1699720888
-
- Specialist
- New York, NY
- NPI 1033153697
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448841600000",
"number": "1285658989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 PARK AVE",
"city": "HUNTINGTON",
"state": "NY",
"postal_code": "117432779",
"telephone_number": "631-659-4491",
"fax_number": "631-659-4580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 PARK AVE",
"city": "HUNTINGTON",
"state": "NY",
"postal_code": "117432779",
"telephone_number": "631-659-4491",
"fax_number": "631-659-4580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DATTWYLER",
"first_name": "RAYMOND",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2015-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "207RA0201X",
"taxonomy_group": "",
"desc": "Internal Medicine, Allergy & Immunology",
"state": "NY",
"license": "145814",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI HMO",
"identifier": "000000090207",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00662840",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIP",
"identifier": "145814",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO",
"identifier": "4589993",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P3453285",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "3738401",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "389284",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "133277785",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI PPO",
"identifier": "2099746",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ATLANTIS",
"identifier": "DR5814",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET",
"identifier": "3C7116",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIP",
"identifier": "145814",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Huntington, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.