Individual provider Active NPI

Yvonne Rifaat Rizk, MD

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Raynham, MA
National Provider Identifier
1417968348
Registry record updated Sep 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084P2900X
License
75120 Issued in MA
Practice address
675 Paramount Dr
Raynham, MA 02767-5416
Phone
(508) 880-0012
Fax
(866) 262-4460
NPI assigned
Aug 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X 75120 MA
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X 75120 MA
Pain Medicine (Psychiatry & Neurology) Physician 2084P2900X 75120 MA Primary

Addresses

Primary practice location

675 Paramount Dr
Raynham, MA 02767-5416

Mailing address

675 Paramount Dr
Raynham, MA 02767-5416
Phone (508) 880-0012

Other identifiers 1

IdentifierTypeStateIssuer
J25484OtherMABCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20050310000865 MA Practitioner - Interventional Pain Management 1850345992 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
75120MAMDClinical Pathology/Laboratory Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care Medical Associates of Massachusetts, LLC Current Accepting new patients
Tristan Medical PC CurrentSince Aug 25, 2010 Accepting new patients

Locations

1340 Belmont St
Brockton, MA 02301
Phone (508) 559-5108

675 Paramount Dr
Raynham, MA 02767
Phone (508) 828-5848

675 Paramount Dr
Ste 203
Raynham, MA 02767
Phone (508) 738-6740

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3082/brand/1/csg/22/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285027200000",
    "number": "1417968348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 PARAMOUNT DR",
            "city": "RAYNHAM",
            "state": "MA",
            "postal_code": "027675416",
            "telephone_number": "508-880-0012",
            "fax_number": "866-262-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 PARAMOUNT DR",
            "city": "RAYNHAM",
            "state": "MA",
            "postal_code": "027675416",
            "telephone_number": "508-880-0012",
            "fax_number": "866-262-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIZK",
        "first_name": "YVONNE",
        "middle_name": "RIFAAT",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2010-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "MA",
            "license": "75120",
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "MA",
            "license": "75120",
            "primary": false
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": "MA",
            "license": "75120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "J25484",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raynham, MA

Sources for this page

Verify at the official NPI Registry.