Active NPI
Matthew Rausch, DMD
- Pediatric Dentistry
- Baldwinsville, NY
National Provider Identifier
1457748097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- NEW GRAD
- Practice address
- 36 Division St
Baldwinsville, NY 13027-2302 - Phone
- (315) 944-8988
- NPI assigned
- Apr 21, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | NEW GRAD | PA | Primary |
Addresses
Primary practice location
36 Division St
Baldwinsville, NY 13027-2302
Mailing address
36 Division St
Baldwinsville, NY 13027-2302
Phone (315) 944-8988
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NEW GRAD | PA | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429574400000",
"number": "1457748097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36 DIVISION ST",
"city": "BALDWINSVILLE",
"state": "NY",
"postal_code": "130272302",
"telephone_number": "315-944-8988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36 DIVISION ST",
"city": "BALDWINSVILLE",
"state": "NY",
"postal_code": "130272302",
"telephone_number": "315-944-8988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAUSCH",
"first_name": "MATTHEW",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-04-21",
"last_updated": "2015-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "PA",
"license": "NEW GRAD",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baldwinsville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.