Organization Active NPI

Bernd Raphael, MD, PA

  • Specialist
  • Lehigh Acres, FL
National Provider Identifier
1669651261
Registry record updated Oct 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME85508 Issued in FL
Legal business name
BERND RAPHAEL, MD, PA
Practice address
470 Lee Blvd
Lehigh Acres, FL 33936-4923
Phone
(239) 368-7270
NPI assigned
Oct 31, 2007
Last updated
Oct 31, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2007

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

Authorized official

Name
Mrs. Jeannette Williams
Title
Office Assistant
Phone
(239) 368-7270

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME85508 FL Primary

Addresses

Primary practice location

470 Lee Blvd
Lehigh Acres, FL 33936-4923

Mailing address

470 Lee Blvd
Lehigh Acres, FL 33936-4923

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040716000506 FL Part B Supplier - Clinic/Group Practice 9436138088 Receives reassigned benefits from 2 practitioners
Practice locations: Lehigh Acres, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1010127Bernd Raphael MD PA470 Lee Blvd, Lehigh Acres, FL 33936Certificate of waiverMar 5, 2027

National Provider Directory

National Provider Directory

Locations

470 Lee Blvd
Lehigh Acres, FL 33936
Phone (239) 368-7270

Practitioners & affiliated clinicians

Practitioners 2

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": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1669651261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 LEE BLVD",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339364923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 LEE BLVD",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339364923",
            "telephone_number": "239-368-7270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERND RAPHAEL, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JEANNETTE",
        "authorized_official_title_or_position": "OFFICE ASSISTANT",
        "authorized_official_telephone_number": "239-368-7270",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME85508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehigh Acres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.