Individual provider Active NPI

Jacob Robert Raskin

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1639864457
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
C1-0029402 Issued in DE
Practice address
1020 Sansom St Ste 1651B
Philadelphia, PA 19107-5002
Phone
(215) 955-9837
Fax
(215) 955-9870
NPI assigned
Apr 7, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X C1-0029402 DE Primary

Addresses

Primary practice location

1020 Sansom St Ste 1651B
Philadelphia, PA 19107-5002

Mailing address

1020 Sansom St Ste 1651B
Philadelphia, PA 19107-5002
Phone (215) 955-9837

Other practice location 1

4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Phone (302) 733-1806

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20230605001572 PA Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 2365809423

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Virginia Commonwealth University, School of Medicine, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4000 Nexus Dr
Wilmington, DE 19803-3000

4755 Ogletown Stanton Rd
Newark, DE 19718-2200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1680825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1639864457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 SANSOM ST STE 1651B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075002",
            "telephone_number": "215-955-9837",
            "fax_number": "215-955-9870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 SANSOM ST STE 1651B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075002",
            "telephone_number": "215-955-9837",
            "fax_number": "215-955-9870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4755 Ogletown Stanton Rd",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197182200",
            "country_code": "US",
            "telephone_number": "302-733-1806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RASKIN",
        "first_name": "JACOB",
        "middle_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-07",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "DE",
            "license": "C1-0029402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.