Individual provider Active NPI

Tina N Raciti

  • Specialist
  • Bronx, NY
National Provider Identifier
1639524184
Registry record updated May 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1025604161 Issued in NY
Practice address
1644 Yates Ave
Bronx, NY 10461-2002
Phone
(917) 612-0774
NPI assigned
May 3, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1025758161 NY
Specialist 174400000X 1029619161 NY
Specialist 174400000X 1025604161 NY Primary

Addresses

Primary practice location

1644 Yates Ave
Bronx, NY 10461-2002

Mailing address

1644 Yates Ave
Bronx, NY 10461-2002
Phone (917) 612-0774

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

LicenseStateTypeSpecialty
1025604161NYMDSpecialist
1025758161NYMDSpecialist
1029619161NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1462233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462233600000",
    "number": "1639524184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1644 YATES AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612002",
            "telephone_number": "917-612-0774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1644 YATES AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612002",
            "telephone_number": "917-612-0774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACITI",
        "first_name": "TINA",
        "middle_name": "N",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-03",
        "last_updated": "2016-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1025758161",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1029619161",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1025604161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2016; 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.