Organization Active NPI

Colon Rectal Surgery Associates PC

  • Colon & Rectal Surgery Physician
  • Allentown, PA
National Provider Identifier
1629027388
Registry record updated Jan 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
Legal business name
COLON RECTAL SURGERY ASSOCIATES PC
Practice address
1255 S Cedar Crest Blvd
Suite 3900
Allentown, PA 18103-6256
Phone
(610) 402-1095
Fax
(610) 435-5003
NPI assigned
May 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2019

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

Authorized official

Name
Mikhail I Rakhmanine, M.D.NPI 1326028705
Title
Physician/Owner
Phone
(484) 788-0840

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208C00000X Primary

Addresses

Primary practice location

1255 S Cedar Crest Blvd
Suite 3900
Allentown, PA 18103-6256

Mailing address

1255 S. Cedar Crest Blvd
Suite 3900
Allentown, PA 18103-6256
Phone (484) 788-0852

Other identifiers 12

IdentifierTypeStateIssuer
0827441000OtherPAKEYSTONE EAST
1514773OtherPAGATEWAY HEALTH PLAN
796986OtherPAHIGHMARK BLUE SHIELD
02352400OtherPACAPITAL BLUE CROSS
619529OtherPAAETNA HMO
235HOtherPAGEISINGER HEALTH PLAN
DA9831OtherPARAILROAD MEDICARE
0827441000OtherPAAMERIHEALTH (IBC)
1062660OtherPAAMERIHEALTH MERCY
796986OtherPAKEYSTONE CENTRAL
796986OtherPAOXFORD HEALTH PLAN
152887OtherPATHREE RIVERS/UNISON

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040630000490 PA Part B Supplier - Clinic/Group Practice 7618954421 Receives reassigned benefits from 6 practitioners
Practice locations: Allentown, PA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D0989451Colon Rectal Surgery Associates1255 S Cedar Crest Blvd, Allentown, PA 18103Certificate of waiverSep 20, 2027

National Provider Directory

National Provider Directory

Locations

1230 S Cedar Crest Blvd
Ste 303
Allentown, PA 18103
Phone (610) 402-1095

3147 College Heights Blvd
Allentown, PA 18104
Phone (610) 841-2432

2045 Westgate Dr
Ste 305
Bethlehem, PA 18017
Phone (610) 867-0832

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548892800000",
    "number": "1629027388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 S. CEDAR CREST BLVD",
            "address_2": "SUITE 3900",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036256",
            "telephone_number": "484-788-0852",
            "fax_number": "610-435-5003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 S CEDAR CREST BLVD",
            "address_2": "SUITE 3900",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036256",
            "telephone_number": "610-402-1095",
            "fax_number": "610-435-5003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLON RECTAL SURGERY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2019-01-31",
        "status": "A",
        "authorized_official_last_name": "RAKHMANINE",
        "authorized_official_first_name": "MIKHAIL",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "484-788-0840",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE EAST",
            "identifier": "0827441000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY HEALTH PLAN",
            "identifier": "1514773",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "796986",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "02352400",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "619529",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER HEALTH PLAN",
            "identifier": "235H",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA9831",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH (IBC)",
            "identifier": "0827441000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY",
            "identifier": "1062660",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE CENTRAL",
            "identifier": "796986",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLAN",
            "identifier": "796986",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THREE RIVERS/UNISON",
            "identifier": "152887",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.