Individual provider Active NPI

Leonidas W Raisis, MD

  • Orthopaedic Surgery Physician
  • Newark, DE
National Provider Identifier
1629058540
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
CI0002996 Issued in DE
Practice address
4745 Ogletown Stanton Rd Ste 225
Newark, DE 19713-1387
Phone
(302) 731-2888
Fax
(302) 731-7049
NPI assigned
Jan 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X CI0002996 DE Primary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X CI0002996 DE

Addresses

Primary practice location

4745 Ogletown Stanton Rd Ste 225
Newark, DE 19713-1387

Mailing address

211 Executive Dr Ste 11
Newark, DE 19702-3358
Phone (302) 731-2888

Other names 1

  • Leo W Raisis Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20100213000007 DE Practitioner - Orthopedic Surgery 2769455393

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.8 of 100Reported as group
Quality
96
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CI0002996DEMDOrthopaedic Surgery Physician

Interoperability endpoints

  • Direct secure messaging: leo.raisismd.p1@direct.fsoortho.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1629058540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 EXECUTIVE DR STE 11",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197023358",
            "telephone_number": "302-731-2888",
            "fax_number": "302-731-7049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 OGLETOWN STANTON RD STE 225",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197131387",
            "telephone_number": "302-731-2888",
            "fax_number": "302-731-7049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAISIS",
        "first_name": "LEONIDAS",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "DE",
            "license": "CI0002996",
            "primary": true
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "DE",
            "license": "CI0002996",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEO",
            "last_name": "RAISIS",
            "middle_name": "W",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.