Active NPI
Steven Barry Raphael, D.D.S.
- General Practice Dentistry
- Chicago, IL
National Provider Identifier
1366645657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 60491
- Practice address
- 801 S Paulina St
#301D
Chicago, IL 60612-7210 - Phone
- (312) 355-3615
- NPI assigned
- Jun 6, 2007
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 60491 | KS | Primary |
Addresses
Primary practice location
801 S Paulina St
#301D
Chicago, IL 60612-7210
Mailing address
360 E South Water St
#4102
Chicago, IL 60601-4028
Phone (913) 723-1313
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140923000085 | MO | Order and Referring Only - Oral Surgery | 0749409803 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60491 | KS | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Steven B. Raphael, D.D.S., P.C. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Endodontics
- Chicago, IL
- NPI 1720366594
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302480000000",
"number": "1366645657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "360 E SOUTH WATER ST",
"address_2": "#4102",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606014028",
"telephone_number": "913-723-1313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 S PAULINA ST",
"address_2": "#301D",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606127210",
"telephone_number": "312-355-3615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAPHAEL",
"first_name": "STEVEN",
"middle_name": "BARRY",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-06",
"last_updated": "2011-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "KS",
"license": "60491",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.