Individual provider Active NPI

Rakiya Watts, CNM

  • Advanced Practice Midwife
  • Stony Brook, NY
National Provider Identifier
1396032207
Registry record updated Mar 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
F001433 Issued in NY
Practice address
University Associates in OB GYN
Stony Brook University Hospital, HSC Level 9, Room 090
Stony Brook, NY 11794-8091
Phone
(631) 444-3987
Fax
(631) 444-8954
NPI assigned
Jun 30, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X F001433 NY Primary

Addresses

Primary practice location

University Associates in OB GYN
Stony Brook University Hospital, HSC Level 9, Room 090
Stony Brook, NY 11794-8091

Mailing address

PO Box 1559
Stony Brook, NY 11790-0989
Phone (631) 444-3987

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120404000095 NY Practitioner - Certified Nurse Midwife (CNM) 0648430348 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4875 Sunrise Hwy
Suite 200
Bohemia, NY 11716-4630
Phone (631) 638-4401

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
F001433NYMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
University Associates in Obstetrics & Gynecology, University Faculty P CurrentSince Apr 3, 2017 Accepting new patients
Jamaica Hospital CurrentSince May 3, 2012 Accepting new patients
Jamaica Hospital CurrentSince May 3, 2012 Accepting new patients
University Hospital at Stony Brook Current Accepting new patients

Locations

4875 Sunrise Hwy
Ste 200
Bohemia, NY 11716
Phone (631) 638-4401

11120 Merrick Blvd
Jamaica, NY 11433
Phone (718) 206-7510

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

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

Networks

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

Interoperability endpoints

  • Direct secure messaging: rakiya.watts@direct.stonybrookmedicine.edu

Organizations & group practices 4

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": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490918400000",
    "number": "1396032207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900989",
            "telephone_number": "631-444-3987",
            "fax_number": "631-444-8954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY ASSOCIATES IN OB GYN",
            "address_2": "STONY BROOK UNIVERSITY HOSPITAL, HSC LEVEL 9, ROOM 090",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948091",
            "telephone_number": "631-444-3987",
            "fax_number": "631-444-8954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTS",
        "first_name": "RAKIYA",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-30",
        "last_updated": "2017-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": "F001433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.