Individual provider Active NPI

John Carl Raiss, M.D.

  • Child & Adolescent Psychiatry Physician
  • Santa Monica, CA
National Provider Identifier
1467465997
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
C38948 Issued in CA
Practice address
2021 Santa Monica Blvd
Suite 750-E
Santa Monica, CA 90404-2208
Phone
(310) 829-4787
Fax
(310) 829-4057
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X C38948 CA
Child & Adolescent Psychiatry Physician 2084P0804X C38948 CA Primary

Addresses

Primary practice location

2021 Santa Monica Blvd
Suite 750-E
Santa Monica, CA 90404-2208

Mailing address

2021 Santa Monica Blvd
Suite 750-E
Santa Monica, CA 90404-2208
Phone (310) 829-4787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jun 2, 2014 through Jun 2, 2028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38948CAMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1467465997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 SANTA MONICA BLVD",
            "address_2": "SUITE 750-E",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042208",
            "telephone_number": "310-829-4787",
            "fax_number": "310-829-4057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 SANTA MONICA BLVD",
            "address_2": "SUITE 750-E",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042208",
            "telephone_number": "310-829-4787",
            "fax_number": "310-829-4057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAISS",
        "first_name": "JOHN",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C38948",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "C38948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.