Individual provider Active NPI

Louis J Raimondo, MD

  • Psychiatry Physician
  • Ormond Beach, FL
National Provider Identifier
1679580195
Registry record updated Jan 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME0056503 Issued in FL
Practice address
595 W Granada Blvd
Suite 2E
Ormond Beach, FL 32174-5190
Phone
(386) 672-4222
Fax
(386) 672-8855
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2013

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychiatry Physician 2084F0202X ME0056503 FL
Psychiatry Physician 2084P0800X ME0056503 FL Primary
Addiction Psychiatry Physician 2084P0802X ME0053503 FL
Child & Adolescent Psychiatry Physician 2084P0804X ME0056503 FL
Geriatric Psychiatry Physician 2084P0805X ME0056503 FL

Addresses

Primary practice location

595 W Granada Blvd
Suite 2E
Ormond Beach, FL 32174-5190

Mailing address

595 W Granada Blvd
Suite 2E
Ormond Beach, FL 32174-5190
Phone (386) 672-4222

Other identifiers 1

IdentifierTypeStateIssuer
061961200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20120301000392 FL Practitioner - Psychiatry 9739347212 Practice locations: Ormond Beach, FL

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
State University of New York at Buffalo School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

595 W Granada Blvd
2E
Ormond Beach, FL 32174-5190
Phone (386) 672-4222

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358899200000",
    "number": "1679580195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 W GRANADA BLVD",
            "address_2": "SUITE 2E",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745190",
            "telephone_number": "386-672-4222",
            "fax_number": "386-672-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 W GRANADA BLVD",
            "address_2": "SUITE 2E",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745190",
            "telephone_number": "386-672-4222",
            "fax_number": "386-672-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAIMONDO",
        "first_name": "LOUIS",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2013-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "FL",
            "license": "ME0056503",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME0056503",
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "FL",
            "license": "ME0053503",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "FL",
            "license": "ME0056503",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "FL",
            "license": "ME0056503",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "061961200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

Verify at the official NPI Registry.