Individual provider Active NPI

Robert Diraimo, M.D

  • Specialist
  • Port Washington, NY
National Provider Identifier
1639119100
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
210599 Issued in NY
Practice address
639 Port Washington Blvd
Port Washington, NY 11050-3733
Phone
(516) 883-2212
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 210599 NY Primary

Addresses

Primary practice location

639 Port Washington Blvd
Port Washington, NY 11050-3733

Mailing address

45 E Gate
Manhasset, NY 11030-3423
Phone (516) 365-4792

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040319000918 NY Practitioner - Vascular SurgeryPractitioner - General Surgery 8426948530 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians of Brooklyn, Inc. CurrentSince Jul 12, 2011 Accepting new patients
University Physicians of Brooklyn, Inc. CurrentSince Jul 12, 2011 Accepting new patients
Coney Island Medical Practice Plan, P.C. CurrentSince Mar 1, 2020 Accepting new patients
North Shore-Lij Medical PC Past Accepting new patients
Mark Gennaro MD PC PastSince Sep 17, 1999 Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

450 Clarkson Ave
#80
Brooklyn, NY 11203
Phone (718) 613-8481

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

450 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 270-1603

3839 Flatlands Ave
Ste 100
Brooklyn, NY 11234
Phone (718) 338-5024

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: robertdiraimo@sunydmc.allscriptsdirect.net
  • Direct secure messaging: robert.diraimo.1@438.direct.athenahealth.com
  • Direct secure messaging: rdiraimo840976@nychhc.direct-ci.com

Organizations & group practices 7

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1639119100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 E GATE",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303423",
            "telephone_number": "516-365-4792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 PORT WASHINGTON BLVD",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110503733",
            "telephone_number": "516-883-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIRAIMO",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "210599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Washington, NY

Sources for this page

Verify at the official NPI Registry.