Organization Active NPI

Rapha Clinic Inc

  • Podiatrist
  • Shoreline, WA
National Provider Identifier
1295934438
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
RAPHA CLINIC INC
Practice address
1130 N 185TH St Ste 200
Shoreline, WA 98133-4011
Phone
(206) 542-1000
Fax
(206) 542-5353
NPI assigned
Jul 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Authorized official

Name
Dr. John Y Joo, DPMNPI 1720083652
Title
President
Phone
(206) 542-5323

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

1130 N 185TH St Ste 200
Shoreline, WA 98133-4011

Mailing address

1130 N 185TH St Ste 200
Shoreline, WA 98133-4011
Phone (206) 542-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040408001104 WA Part B Supplier - Clinic/Group Practice 2264426790 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
Practice locations: Cle Elum, WA; Shoreline, WA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

201 Alpha Way
Cle Elum, WA 98922
Phone (509) 674-5331

1130 N 185th St
Ste 200
Shoreline, WA 98133
Phone (206) 542-1000

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720483200000",
    "number": "1295934438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 N 185TH ST STE 200",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981334011",
            "telephone_number": "206-542-1000",
            "fax_number": "206-542-5353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 N 185TH ST STE 200",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981334011",
            "telephone_number": "206-542-1000",
            "fax_number": "206-542-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAPHA CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-17",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A",
        "authorized_official_last_name": "JOO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "206-542-5323",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.