Individual provider Active NPI

Raphael Luis Vazquez, M.D.

  • Ophthalmology Physician
  • New York, NY
National Provider Identifier
1578634614
Registry record updated Jul 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
135505 Issued in NY
Practice address
285 Fort Washington Ave
New York, NY 10032-1206
Phone
(212) 927-0060
Fax
(212) 923-3359
NPI assigned
Nov 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 135505 NY
Ophthalmology Physician 207W00000X 135505 NY Primary

Addresses

Primary practice location

285 Fort Washington Ave
New York, NY 10032-1206

Mailing address

15 Cornelia Dr
Greenwich, CT 06830-3906
Phone (203) 542-5184

Other identifiers 1

IdentifierTypeStateIssuer
00385488MedicaidNY

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
I20110223000401 NY Practitioner - Ophthalmology 1850572983 Practice locations: Bronx, NY; New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Columbia University College of Physicians and Surgeons, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

285 Fort Washignton Ave
New York, NY 10032-1206
Phone (212) 927-0060

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
135505NYMDOphthalmology Physician

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

NPI Registry JSON

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

{
    "created_epoch": "1163289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279065600000",
    "number": "1578634614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 CORNELIA DR",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068303906",
            "telephone_number": "203-542-5184",
            "fax_number": "203-542-5184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 FORT WASHINGTON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321206",
            "telephone_number": "212-927-0060",
            "fax_number": "212-923-3359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "RAPHAEL",
        "middle_name": "LUIS",
        "name_prefix": "Prof.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-12",
        "last_updated": "2010-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "135505",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "135505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00385488",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.