Individual provider Active NPI

Aviva H Raskas, M.D.

  • Psychiatry Physician
  • Saint Louis, MO
National Provider Identifier
1447295191
Registry record updated Feb 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2002011264 Issued in MO
Practice address
8420 Delmar Blvd
505
Saint Louis, MO 63124-2170
Phone
(314) 749-6621
Fax
(314) 569-3162
NPI assigned
Jun 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 2002011264 MO
Psychiatry Physician 2084P0800X 2002011264 MO Primary

Addresses

Primary practice location

8420 Delmar Blvd
505
Saint Louis, MO 63124-2170

Mailing address

PO Box 957723
Saint Louis, MO 63195-7723
Phone (314) 432-2580

Other identifiers 7

IdentifierTypeStateIssuer
201422OtherMOBLUECHOICE
P00278493OtherMOINDIVIDUAL PROV#
201766046OtherMOTAX ID#
201911OtherMOBCBS
207205501MedicaidMO
266892OtherMOGHP/CMR
731022OtherMOHEALTHLINK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20050826000387 MO Practitioner - Psychiatry 6204867534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Albert Einstein College of Medicine of Yeshiva University, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 Woodland Manor
Woodland Manor Nursing Home
Arnold, MO 63010-2030
Phone (636) 296-1400

8600 Delmar Blvd
FL 12
Saint Louis, MO 63124-1973
Phone (314) 995-3811

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2002011264MOMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aviva H Raskas, MD LLC Specialist CurrentSince Oct 8, 2004 Accepting new patients

Locations

8600 Delmar Blvd
Fl 12
Saint Louis, MO 63124
Phone (314) 994-0432

8420 Delmar Blvd
Ste 505
Saint Louis, MO 63124
Phone (314) 432-1700

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": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391385600000",
    "number": "1447295191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 957723",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631957723",
            "telephone_number": "314-432-2580",
            "fax_number": "314-569-3162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8420 DELMAR BLVD",
            "address_2": "505",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631242170",
            "telephone_number": "314-749-6621",
            "fax_number": "314-569-3162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASKAS",
        "first_name": "AVIVA",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2014-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MO",
            "license": "2002011264",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2002011264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECHOICE",
            "identifier": "201422",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PROV#",
            "identifier": "P00278493",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID#",
            "identifier": "201766046",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "201911",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207205501",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP/CMR",
            "identifier": "266892",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "731022",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.