Individual provider Active NPI

Micheal Herswin Raj, M.D.

  • Diagnostic Radiology Physician
  • New York, NY
National Provider Identifier
1598049470
Registry record updated Jul 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
262963 Issued in NY
Practice address
1275 York Ave
New York, NY 10065-6007
Phone
(631) 968-3000
NPI assigned
Oct 10, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 262963 NY Primary

Addresses

Primary practice location

1275 York Ave
New York, NY 10065-6007

Mailing address

301 E Main St
Bay Shore, NY 11706-8408

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
I20151130000500 NY Practitioner - Diagnostic Radiology 9931409877 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
State Un of Ny, Buffalo School of Dental Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

1220 Hicksville Rd
Seaford, NY 11783-1604
Phone (516) 266-3456

27005 75TH Ave
New Hyde Park, NY 11040-1402
Phone (718) 470-7000

Hospital & facility affiliations

  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
  • Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195
  • John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185
  • NS/Lij HS Huntington Hospital Hospital, Huntington, NY, CCN 330045
  • Phelps Hospital Hospital, Sleepy Hollow, NY, CCN 330261

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
262963NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mskcc Radiology Group Diagnostic Radiology CurrentSince Sep 18, 2015 Accepting new patients
North Shore-Lij Medical PC CurrentSince Jul 1, 2016 Accepting new patients
Southside Faculty Medical Affiliates University Faculty Practice Corp CurrentSince Aug 1, 2021 Accepting new patients

Locations

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

300 Community Dr
Plandome, NY 11030

9525 Queens Blvd
Frnt 2
Rego Park, NY 11374
Phone (718) 360-5522

1220 Hicksville Rd
Seaford, NY 11783

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: mraj68698@northwell.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1318204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468281600000",
    "number": "1598049470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "631-968-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJ",
        "first_name": "MICHEAL",
        "middle_name": "HERSWIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-10",
        "last_updated": "2016-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "262963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.