Individual provider Active NPI

Raphael Lanier Hamilton

  • Dentist
  • Brooklyn, NY
National Provider Identifier
1376857649
Registry record updated Jul 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
054281 Issued in NY
Practice address
947 Manhattan Ave
Brooklyn, NY 11222
Phone
(718) 389-4266
Fax
(718) 389-7859
NPI assigned
Jul 29, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 054281 NY Primary

Addresses

Primary practice location

947 Manhattan Ave
Brooklyn, NY 11222

Mailing address

947 Manhattan Ave
Brooklyn, NY 11222
Phone (718) 389-4266

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
I20220314000307 NY Practitioner - Dentist 8022316819 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
054281NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
William F Ryan Community Health Center Inc CurrentSince Dec 2, 2021 Accepting new patients
William F Ryan Community Health Center Inc CurrentSince Dec 2, 2021 Accepting new patients
Ryan-Chelsea Clinton Community Health Center Past Accepting new patients

Locations

110 W 97th St
New York, NY 10025
Phone (212) 316-7906

154 Wadsworth Ave
New York, NY 10033
Phone (212) 531-7589

110 W 97th St
#0
New York, NY 10025

279 E 3rd St
New York, NY 10009
Phone (212) 477-8500

Interoperability endpoints

  • Direct secure messaging: raphael.hamilton@wfrchc.eclinicaldirectplus.com

Organizations & group practices 3

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": "1280361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280361600000",
    "number": "1376857649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "947 MANHATTAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11222",
            "telephone_number": "718-389-4266",
            "fax_number": "718-389-7259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "947 MANHATTAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11222",
            "telephone_number": "718-389-4266",
            "fax_number": "718-389-7859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "RAPHAEL",
        "middle_name": "LANIER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-29",
        "last_updated": "2010-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "054281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.