Organization Active NPI

Rapha Foot and Ankle Center, Inc

  • Foot & Ankle Surgery Podiatrist
  • Philadelphia, PA
National Provider Identifier
1629576350
Registry record updated Jan 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
RAPHA FOOT AND ANKLE CENTER, INC
Practice address
4605 Frankford Ave
Philadelphia, PA 19124-5803
Phone
(215) 289-7007
Fax
(215) 289-3400
NPI assigned
Jan 29, 2018
Last updated
Jan 29, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2018

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

Authorized official

Name
Jong Lee, DPMNPI 1205915444
Title
Owner
Phone
(267) 974-8705

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X NU Primary

Addresses

Primary practice location

4605 Frankford Ave
Philadelphia, PA 19124-5803

Mailing address

4605 Frankford Ave
Philadelphia, PA 19124-5803
Phone (215) 289-7007

Other identifiers 1

IdentifierTypeStateIssuer
1009302350001MedicaidPA

National Provider Directory

National Provider Directory

Locations

1909 E Washington Ln
Philadelphia, PA 19138
Phone (215) 549-5900

4605 Frankford Ave
Philadelphia, PA 19124
Phone (215) 289-7007

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1517184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517184000000",
    "number": "1629576350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4605 FRANKFORD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191245803",
            "telephone_number": "215-289-7007",
            "fax_number": "215-289-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 FRANKFORD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191245803",
            "telephone_number": "215-289-7007",
            "fax_number": "215-289-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAPHA FOOT AND ANKLE CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-29",
        "last_updated": "2018-01-29",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JONG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-974-8705",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1009302350001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.