Individual provider Active NPI

Ryan Raffaelli, M.D.

  • Pediatric Nephrology Physician
  • Philadelphia, PA
National Provider Identifier
1477672079
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
MD 428387 Issued in PA
Practice address
34TH St and Civic Center Blvd
Children's Hospital of Philadelphia
Philadelphia, PA 19104
Phone
(215) 590-2449
NPI assigned
Mar 28, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nephrology Physician 2080P0210X MD 428387 PA Primary

Addresses

Primary practice location

34TH St and Civic Center Blvd
Children's Hospital of Philadelphia
Philadelphia, PA 19104

Mailing address

34TH St and Civic Center Blvd
Children's Hospital of Philadelphia
Philadelphia, PA 19104
Phone (215) 590-2449

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD 428387PAMDPediatric Nephrology Physician

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477672079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34TH ST AND CIVIC CENTER BLVD",
            "address_2": "CHILDREN'S HOSPITAL OF PHILADELPHIA",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-590-2449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34TH ST AND CIVIC CENTER BLVD",
            "address_2": "CHILDREN'S HOSPITAL OF PHILADELPHIA",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-590-2449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFFAELLI",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "PA",
            "license": "MD 428387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.