Individual provider Active NPI

Raphael Davis, M.D.

  • Neurological Surgery Physician
  • East Setauket, NY
National Provider Identifier
1386674810
Registry record updated Jun 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
150592 Issued in NY
Practice address
24 Research Way Suite 200
New York Spine and Brain Surgery
East Setauket, NY 11733
Phone
(631) 444-1213
Fax
(631) 444-1535
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 150592 NY Primary

Addresses

Primary practice location

24 Research Way Suite 200
New York Spine and Brain Surgery
East Setauket, NY 11733

Mailing address

New York Spine and Brain Surgery
HSC T12 RM 080
Stony Brook, NY 11794-8122
Phone (631) 444-1213

Other identifiers 3

IdentifierTypeStateIssuer
01018111MedicaidNY
4286750OtherNYAETNA
96D48OtherNYEMPIRE BC.BS

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100224000317 NY Practitioner - Neurosurgery 2567352230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Icahn School of Medicine at Mount Sinai, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Lauterbur Dr
Stony Brook Cancer Center
Stony Brook, NY 11794-0001
Phone (631) 444-1213

100 Nicolls Rd
Stony Brook, NY 11794-8122
Phone (631) 444-1213

101 Nicolls Rd
Stony Brook, NY 11794-8122
Phone (631) 444-1213

Hospital & facility affiliations

  • Catholic Home Care Home health agency, Farmingdale, NY, CCN 337147
  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393
  • Peconic Bay Medical Center Hospital, Riverhead, NY, CCN 330107

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion175
Laminectomy or laminotomy (partial removal of spine bones)88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
New York Spine & Brain Surgery, University Faculty Practice Corporatio Neurological Surgery CurrentSince Jul 1, 1983 Accepting new patients
Neurology Associates of Stony Brook, University Faculty Practice Corpo Past Accepting new patients

Locations

24 Research Way
Ste 200
East Setauket, NY 11733
Phone (631) 444-1210

54 Commerce Ave
Ste 7
Riverhead, NY 11901
Phone (631) 444-1210

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: raphael.davis@direct.stonybrookmedicine.edu

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402876800000",
    "number": "1386674810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NEW YORK SPINE AND BRAIN SURGERY",
            "address_2": "HSC T12 RM 080",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948122",
            "telephone_number": "631-444-1213",
            "fax_number": "631-444-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 RESEARCH WAY SUITE 200",
            "address_2": "NEW YORK SPINE AND BRAIN SURGERY",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "11733",
            "telephone_number": "631-444-1213",
            "fax_number": "631-444-1535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "RAPHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2014-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NY",
            "license": "150592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01018111",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4286750",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC.BS",
            "identifier": "96D48",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.