Individual provider Active NPI

Leonard Irwin Raifman, M.D.

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1518967199
Registry record updated Sep 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
121745 Issued in NY
Practice address
1000 Park Ave
New York, NY 10028-0934
Phone
(212) 734-8821
Fax
(212) 734-9615
NPI assigned
Jul 26, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 121745 NY Primary

Addresses

Primary practice location

1000 Park Ave
New York, NY 10028-0934

Mailing address

1000 Park Ave
New York, NY 10028-0934
Phone (212) 734-8821

Other identifiers 13

IdentifierTypeStateIssuer
110236106OtherNYRAILROAD MEDICARE
0730576OtherNYCIGNA
133128491OtherNYTAX ID
164052OtherNYELDER PLAN
PC654OtherNYCENTER CARE
OC1735OtherNYHEALTHNET
00656051MedicaidNY
0M089POtherNYHIP
110008479OtherNYUNITED HEATHCARE
NP263OtherNYOXFORD HEALTH PLANS
009599 99OtherNYGHI
070932OtherNYAETNA
121245 A20OtherNYHEALTHFIRST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110201000664 NY Practitioner - Internal Medicine 7618156001 Practice locations: New York, NY

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1518967199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100280934",
            "telephone_number": "212-734-8821",
            "fax_number": "212-734-9615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100280934",
            "telephone_number": "212-734-8821",
            "fax_number": "212-734-9615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAIFMAN",
        "first_name": "LEONARD",
        "middle_name": "IRWIN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2012-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "121745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110236106",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0730576",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "133128491",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ELDER PLAN",
            "identifier": "164052",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CENTER CARE",
            "identifier": "PC654",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "OC1735",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00656051",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "0M089P",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEATHCARE",
            "identifier": "110008479",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLANS",
            "identifier": "NP263",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "009599 99",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "070932",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHFIRST",
            "identifier": "121245 A20",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.