Active NPI
Edmond J Raker, MD
- Vascular Surgery Physician
- Seattle, WA
National Provider Identifier
1487703799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- MD00019975
- Practice address
- 1100 9TH Ave
Seattle, WA 98101-2756 - Phone
- (206) 223-6600
- NPI assigned
- Jan 9, 2007
- Last updated
- Feb 22, 2013
- 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 |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | MD00019975 | WA | Primary |
Addresses
Primary practice location
1100 9TH Ave
Seattle, WA 98101-2756
Mailing address
1100 9TH Ave
Ms:M4-PA
Seattle, WA 98101-2756
Phone (206) 515-5811
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 020039454 | Other | WA | RAILROAD MC# |
| 1487703799 | Other | WA | MONTANA MEDICAID |
| 8332405 | Medicaid | WA | |
| 0039588 | Other | WA | LABOR AND INDUSTRIES # |
| MD784WA | Medicaid | AK | |
| R038 | Other | WA | BLUE SHIELD # |
| US0861508 | Other | WA | AETNA SPECIALIST PIN |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- edmond.raker@direct.vmmc.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361491200000",
"number": "1487703799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 9TH AVE",
"address_2": "MS:M4-PA",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981012756",
"telephone_number": "206-515-5811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 9TH AVE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981012756",
"telephone_number": "206-223-6600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAKER",
"first_name": "EDMOND",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-09",
"last_updated": "2013-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "WA",
"license": "MD00019975",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MC#",
"identifier": "020039454",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MONTANA MEDICAID",
"identifier": "1487703799",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8332405",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR AND INDUSTRIES #",
"identifier": "0039588",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MD784WA",
"state": "AK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD #",
"identifier": "R038",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA SPECIALIST PIN",
"identifier": "US0861508",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.