Individual provider Active NPI

Raja Sabbagh, MD

  • Surgery Physician
  • New York, NY
National Provider Identifier
1720199151
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
217205 Issued in NY
Practice address
506 Malcolm X Blvd
Suite 11106B
New York, NY 10037-1802
Phone
(212) 939-4122
Fax
(212) 939-4122
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 217205 NY Primary
Colon & Rectal Surgery Physician 208C00000X 217205 NY
Surgical Critical Care Physician 2086S0102X 217205 NY
Trauma Surgery Physician 2086S0127X 217205 NY

Addresses

Primary practice location

506 Malcolm X Blvd
Suite 11106B
New York, NY 10037-1802

Mailing address

506 Malcolm X Blvd
Suite 11106B
New York, NY 10037-1802
Phone (212) 939-4122

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
I20070613000805 NY Practitioner - General SurgeryPractitioner - Colorectal Surgery (Proctology) 9638277734 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai Surgery CurrentSince Mar 1, 2015 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Mar 1, 2015 Accepting new patients
Downtown Bronx Medical Associates PC CurrentSince Mar 1, 2020 Accepting new patients
Harlem Medical Associates PC CurrentSince Jan 1, 2011 Accepting new patients
Trustees of Columbia University in the City of New York Past Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

234 Eugenio Maria de Hosto Blvd
Bronx, NY 10451
Phone (718) 579-5874

7901 Broadway
Rm A119
Elmhurst, NY 11373
Phone (718) 334-3915

7901 Broadway
#A119
Elmhurst, NY 11373
Phone (718) 334-2488

506 Malcolm X Blvd
#522
New York, NY 10037
Phone (212) 491-1583

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

506 Malcolm X Blvd
Ste 11106B
New York, NY 10037
Phone (212) 939-4122

Networks

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

Interoperability endpoints

  • Direct secure messaging: rsabbagh85273@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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1720199151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 MALCOLM X BLVD",
            "address_2": "SUITE 11106B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100371802",
            "telephone_number": "212-939-4122",
            "fax_number": "212-939-4122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 MALCOLM X BLVD",
            "address_2": "SUITE 11106B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100371802",
            "telephone_number": "212-939-4122",
            "fax_number": "212-939-4122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SABBAGH",
        "first_name": "RAJA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "217205",
            "primary": true
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NY",
            "license": "217205",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NY",
            "license": "217205",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "NY",
            "license": "217205",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.