Individual provider Active NPI

Simon Raskin, DPM

  • Podiatrist
  • Brooklyn, NY
National Provider Identifier
1376526145
Registry record updated Oct 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N005608 Issued in NY
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

Updated by the provider on Oct 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
PK5251OtherNYBLUE CROSS BLUE SHIELD
02195893MedicaidNY

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040426001198 NY Practitioner - Podiatry 5193712933

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N005608NYMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
East Shore Medical PC Past Accepting new patients
Personal Touch Medical Care, P.C. PastSince Aug 13, 1996 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.

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

Verify at the official NPI Registry.