Active NPI
Ryan Raffaelli, M.D.
- Pediatric Nephrology Physician
- Philadelphia, PA
National Provider Identifier
1477672079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nephrology Physician
- License
- MD 428387
- 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, 2007
- 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 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
| License | State | Type | Specialty |
|---|---|---|---|
| MD 428387 | PA | MD | Pediatric 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.