Individual provider Active NPI

Peter Joseph Raia, MD

  • Family Medicine Physician
  • Southampton, NY
National Provider Identifier
1427178508
Registry record updated Dec 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
NY177072 Issued in NY
Practice address
89 Jobs Lane
Southampton, NY 11968-4862
Phone
(631) 283-9526
Fax
(631) 283-6491
NPI assigned
Mar 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NY177072 NY Primary

Addresses

Primary practice location

89 Jobs Lane
Southampton, NY 11968-4862

Mailing address

89 Jobs Lane
Southampton, NY 11968-4862
Phone (631) 283-9526

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
I20120628000577 NY Practitioner - Family Practice 0648435446 Practice locations: Southampton, NY

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

89 Jobs LN
Southampton, NY 11968-4862
Phone (631) 283-9526

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue16
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NY177072NYMDFamily Medicine Physician

Hospital & facility affiliations 6

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": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262131200000",
    "number": "1427178508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 JOBS LANE",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119684862",
            "telephone_number": "631-283-9526",
            "fax_number": "631-283-6491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 JOBS LANE",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119684862",
            "telephone_number": "631-283-9526",
            "fax_number": "631-283-6491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAIA",
        "first_name": "PETER",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2009-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "NY177072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southampton, NY

Sources for this page

Verify at the official NPI Registry.