Active NPI
John Dyson Raffaele, LMSW
- Social Worker
- Woodstock, NY
National Provider Identifier
1619550167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 051587
- Practice address
- 404 Zena Rd
Woodstock, NY 12498-2626 - Phone
- (845) 679-8650
- NPI assigned
- May 3, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 051587 | NY | Primary |
Addresses
Primary practice location
404 Zena Rd
Woodstock, NY 12498-2626
Mailing address
404 Zena Rd
Woodstock, NY 12498-2626
Phone (845) 679-8650
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051587 | NY | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620000000000",
"number": "1619550167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "404 ZENA RD",
"city": "WOODSTOCK",
"state": "NY",
"postal_code": "124982626",
"telephone_number": "845-679-8650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "404 ZENA RD",
"city": "WOODSTOCK",
"state": "NY",
"postal_code": "124982626",
"telephone_number": "845-679-8650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAFFAELE",
"first_name": "JOHN",
"middle_name": "DYSON",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-05-03",
"last_updated": "2021-05-03",
"certification_date": "2021-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker",
"state": "NY",
"license": "051587",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodstock, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.