Rae Medical LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

25MA07844500 Issued in NJ

Legal business name

RAE MEDICAL LLC

Practice address

186 W Market St
Suite 113
Newark, NJ 07103-2783

Phone

(973) 623-4957

Fax

(973) 623-2103

NPI assigned

Oct 3, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Idean C Watkins

Title

Biller

Phone

(973) 623-4957

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JEFCDA

Practitioners 4

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

• Norma A Rae-Layne, M.D.

  • Specialist
  • West Orange, NJ
  • NPI 1609950187
  Medicare reassignment
• Vanessa Pinard

  • Obstetrics & Gynecology Physician
  • West Orange, NJ
  • NPI 1487017703
  NPD
• Yvonne Elizabeth Brown, RN, BSN, MSN, ANP

  • Women's Health Nurse Practitioner
  • West Orange, NJ
  • NPI 1477018273
  NPD (past)
• Paul G Matta, MD

  • Maternal & Fetal Medicine Physician
  • Neptune, NJ
  • NPI 1427014380
  NPD (past)

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

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191369600000",
    "number": "1366639361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 W MARKET ST",
            "address_2": "SUITE 113",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032783",
            "telephone_number": "973-623-4957",
            "fax_number": "973-623-2103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 W MARKET ST",
            "address_2": "SUITE 113",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032783",
            "telephone_number": "973-623-4957",
            "fax_number": "973-623-2103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-03",
        "last_updated": "2007-10-03",
        "status": "A",
        "authorized_official_last_name": "WATKINS",
        "authorized_official_first_name": "IDEAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "973-623-4957",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA07844500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Radiance Carriage LLC
• Radiance Psychiatric Services LLC
• Julie Radice, PTA
• Radu Constantine, M.D. Inc.
• Ryan Eugene Radwanski, MD
• Ryan Adam Raffel, MD
• Maryam Rafique
• Ashley Laurence Bharat Raghu, MB CHB
• Latchman Raghunandan, B.S.
• Maya P Raghuwanshi, MD, MPH

• Specialist in Newark, NJ
• Providers in Newark, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; 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.