Michael Jay Raizen, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

22695 Issued in OH

Practice address

600 W 3Rd St
Mansfield, OH 44906-2633

Phone

(419) 522-1939

NPI assigned

Jun 2, 2005

Last updated

Aug 9, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Denver Health and Hospital Authority

  • General Practice Physician
  • Denver, CO
  • NPI 1477569838
  Medicare reassignment NPD
• Denver Health and Hospital Authority

  • Psychiatric Hospital Unit
  • Denver, CO
  • NPI 1689624942
  NPD

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

{
    "created_epoch": "1117670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281312000000",
    "number": "1417951781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W 3RD ST",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449062633",
            "telephone_number": "419-522-1939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W 3RD ST",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449062633",
            "telephone_number": "419-522-1939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAIZEN",
        "first_name": "MICHAEL",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-02",
        "last_updated": "2010-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "22695",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "106233",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02062339",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Radcliffe
• Collin Edward Rader
• Radiology Associates of Mansfield, Inc
• Sarah R Rager
• Travis Rahe
• Venkatakrishnan Rajaram, M.D
• Bethany Christine Rall
• Uma Ram, R PH
• Palani K Raman, MD
• Crystal Darnell Rambo, LPN

• Dentist in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.