Individual provider Active NPI

Robert Alan Raley, DPM

  • Podiatrist
  • Kankakee, IL
National Provider Identifier
1437211562
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
016003683 Issued in IL
Practice address
70 Meadowview Ctr
Suite 401
Kankakee, IL 60901-2047
Phone
(815) 932-1724
Fax
(815) 932-1729
NPI assigned
Dec 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 016003683 IL Primary

Addresses

Primary practice location

70 Meadowview Ctr
Suite 401
Kankakee, IL 60901-2047

Mailing address

70 Meadowview Ctr
Suite 401
Kankakee, IL 60901-2047
Phone (815) 932-1724

Other identifiers 1

IdentifierTypeStateIssuer
016003683MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20071011000398 IL Practitioner - Podiatry 4486740149 Practice locations: Kankakee, IL

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

70 Meadowview Ctr
Kankakee, IL 60901-2061
Phone (815) 932-1724

70 Meadowview Ctr
Suite 401
Kankakee, IL 60901-2047

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1433
Removal or shaving of skin growth726

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Windy City Anesthesia PC Past Accepting new patients

Organizations & group practices 1

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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437211562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 MEADOWVIEW CTR",
            "address_2": "SUITE 401",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012047",
            "telephone_number": "815-932-1724",
            "fax_number": "815-932-1729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 MEADOWVIEW CTR",
            "address_2": "SUITE 401",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012047",
            "telephone_number": "815-932-1724",
            "fax_number": "815-932-1729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RALEY",
        "first_name": "ROBERT",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016003683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016003683",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kankakee, IL

Sources for this page

Verify at the official NPI Registry.