Active NPI
Simon Raskin, DPM
- Podiatrist
- Brooklyn, NY
National Provider Identifier
1376526145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- N005608
- Practice address
- 1409 Gravesend Neck Rd
Brooklyn, NY 11229-4322 - Phone
- (718) 332-7771
- Fax
- (888) 636-2212
- NPI assigned
- Nov 24, 2005
- 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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | N005608 | NY | Primary |
Addresses
Primary practice location
1409 Gravesend Neck Rd
Brooklyn, NY 11229-4322
Mailing address
1409 Gravesend Neck Rd
Brooklyn, NY 11229-4322
Phone (718) 332-7771
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PK5251 | Other | NY | BLUE CROSS BLUE SHIELD |
| 02195893 | Medicaid | NY |
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040426001198 | NY | Practitioner - Podiatry | 5193712933 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N005608 | NY | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Shore Medical PC | Past | Accepting new patients | |
| Personal Touch Medical Care, P.C. | Past | Accepting new patients |
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
Organizations & group practices 2
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.
-
- Pain Medicine (Physical Medicine & Rehabilitation) Physician
- Brooklyn, NY
- NPI 1477508315
-
- Family Medicine Physician
- Brooklyn, NY
- NPI 1255546925
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381968000000",
"number": "1376526145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1409 GRAVESEND NECK RD",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112294322",
"telephone_number": "718-332-7771",
"fax_number": "718-332-1311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1409 GRAVESEND NECK RD",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112294322",
"telephone_number": "718-332-7771",
"fax_number": "888-636-2212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RASKIN",
"first_name": "SIMON",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-24",
"last_updated": "2013-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "NY",
"license": "N005608",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "PK5251",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02195893",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2013; 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.