Individual provider Active NPI

Paul R Rasa, RPH CCP

  • Pharmacist
  • Ringwood, NJ
National Provider Identifier
1477534071
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI01445600 Issued in NJ
Practice address
55 Skyline Dr
Suite 209
Ringwood, NJ 07456-2037
Phone
(973) 728-5800
Fax
(973) 728-7070
NPI assigned
Nov 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI01445600 NJ Primary
Nutrition Support Pharmacist 1835N1003X 28RI01445600 NJ
Pharmacotherapy Pharmacist 1835P1200X 28RI01445600 NJ
Psychiatric Pharmacist 1835P1300X 28RI01445600 NJ

Addresses

Primary practice location

55 Skyline Dr
Suite 209
Ringwood, NJ 07456-2037

Mailing address

4348 Rubery Dr
Carrollton, TX 75010-1148
Phone (973) 722-7272

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
28RI01445600NJMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
The Rasa Group Inc. Pharmacist 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": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355270400000",
    "number": "1477534071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4348 RUBERY DR",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750101148",
            "telephone_number": "973-722-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 SKYLINE DR",
            "address_2": "SUITE 209",
            "city": "RINGWOOD",
            "state": "NJ",
            "postal_code": "074562037",
            "telephone_number": "973-728-5800",
            "fax_number": "973-728-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASA",
        "first_name": "PAUL",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "RPH CCP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2012-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI01445600",
            "primary": true
        },
        {
            "code": "1835N1003X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Nutrition Support",
            "state": "NJ",
            "license": "28RI01445600",
            "primary": false
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "NJ",
            "license": "28RI01445600",
            "primary": false
        },
        {
            "code": "1835P1300X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Psychiatric",
            "state": "NJ",
            "license": "28RI01445600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ringwood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.