Individual provider Active NPI

Mary S Raleigh, DO

  • Family Medicine Physician
  • Irvine, CA
National Provider Identifier
1457542094
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1968 Issued in ME
Practice address
18818 Teller Ave
Suite 170
Irvine, CA 92612-1678
Phone
(949) 535-2322
Fax
(949) 535-2330
NPI assigned
Aug 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 1968 ME
Family Medicine Physician 207Q00000X 1968 ME Primary

Addresses

Primary practice location

18818 Teller Ave
Suite 170
Irvine, CA 92612-1678

Mailing address

18818 Teller Ave
Suite 170
Irvine, CA 92612-1678
Phone (949) 535-2322

Other identifiers 5

IdentifierTypeStateIssuer
1457542094OtherMEANTHEM
433005099MedicaidME
9807251OtherMEAETNA
1457542094OtherMEMEDICAL NETWORK
AA164093OtherMEHARVARD PILGRIM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150605000194 CA Practitioner - Family Practice 0143397265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

18818 Teller Ave
Suite 170
Irvine, CA 92612-8884
Phone (949) 535-2322

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Restoration Healthcare Inc CurrentSince Mar 16, 2015 Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients

Locations

18818 Teller Ave
Ste 170
Irvine, CA 92612
Phone (949) 535-2322

1057 Gayley Ave
Los Angeles, CA 90024
Phone (800) 404-1963

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11061/brand/1/csg/1/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": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1457542094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18818 TELLER AVE",
            "address_2": "SUITE 170",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926121678",
            "telephone_number": "949-535-2322",
            "fax_number": "949-535-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18818 TELLER AVE",
            "address_2": "SUITE 170",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926121678",
            "telephone_number": "949-535-2322",
            "fax_number": "949-535-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RALEIGH",
        "first_name": "MARY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-08",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "ME",
            "license": "1968",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "1968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "1457542094",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "433005099",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9807251",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL NETWORK",
            "identifier": "1457542094",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "AA164093",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.