Individual provider Active NPI

Roland J Raggio

  • General Practice Dentistry
  • Staten Island, NY
National Provider Identifier
1386945830
Registry record updated Nov 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
041574-1 Issued in NY
Practice address
77 Stage LN
Staten Island, NY 10304-4848
Phone
(973) 464-1558
NPI assigned
Nov 14, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 041574-1 NY Primary

Addresses

Primary practice location

77 Stage LN
Staten Island, NY 10304-4848

Mailing address

731 White Plains Rd
Bronx, NY 10473-2631
Phone (973) 464-1558

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
I20220427000297 NY Practitioner - Dentist 9436546173 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041574-1NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation Current Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Jan 20, 2022 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Jan 20, 2022 Accepting new patients

Locations

1225 Gerard Ave
Bronx, NY 10452
Phone (718) 960-2777

2094 Pitkin Ave
Brooklyn, NY 11207
Phone (718) 240-0400

50 Water St
Fl 3
New York, NY 10004

227 Madison St
New York, NY 10002
Phone (212) 238-7000

227 Madison St
Fl 1
New York, NY 10002
Phone (212) 238-7815

Interoperability endpoints

  • Direct secure messaging: rragggio1939397@nychhc.direct-ci.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": "1289692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289692800000",
    "number": "1386945830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 WHITE PLAINS RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104732631",
            "telephone_number": "973-464-1558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 STAGE LN",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103044848",
            "telephone_number": "973-464-1558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGGIO",
        "first_name": "ROLAND",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-14",
        "last_updated": "2010-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "041574-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.