Individual provider Active NPI

Caterina Raffa, D.M.D

  • Pediatric Dentistry
  • Watertown, MA
National Provider Identifier
1609097336
Registry record updated Apr 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
21040 Issued in MA
Practice address
521 Mount Auburn St
Suite 104
Watertown, MA 02472-4191
Phone
(617) 924-1911
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 21040 MA Primary

Addresses

Primary practice location

521 Mount Auburn St
Suite 104
Watertown, MA 02472-4191

Mailing address

521 Mount Auburn St
Suite 104
Watertown, MA 02472-4191
Phone (617) 924-1911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160331001367 MA Order and Referring Only - DentistPractitioner - Dentist 9739486002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21040MAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Dental Arts Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366070400000",
    "number": "1609097336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 MOUNT AUBURN ST",
            "address_2": "SUITE 104",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024724191",
            "telephone_number": "617-924-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 MOUNT AUBURN ST",
            "address_2": "SUITE 104",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024724191",
            "telephone_number": "617-924-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFFA",
        "first_name": "CATERINA",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2013-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MA",
            "license": "21040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, MA

Sources for this page

Verify at the official NPI Registry.