NPIMap

Individual provider Active NPI

Jay David Raisen, M.D.

  • Otolaryngology Physician
  • Fairfield, OH
National Provider Identifier
1740305473
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
35.152739 Issued in OH
Practice address
2960 Mack Rd Ste 200
Fairfield, OH 45014-5300
Phone
(513) 860-5200
Fax
(513) 860-5037
NPI assigned
Mar 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 014566 ME
Otolaryngology Physician 207Y00000X 11025 ND
Otolaryngology Physician 207Y00000X 38570 MN
Otolaryngology Physician 207Y00000X 35.152739 OH Primary

Addresses

Primary practice location

2960 Mack Rd Ste 200
Fairfield, OH 45014-5300

Mailing address

2960 Mack Rd Ste 200
Fairfield, OH 45014-5300
Phone (513) 860-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, OH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240703002026 IN Practitioner - Otolaryngology 0941244677 Reassigns benefits to 1 organization
I20250502002746 OH Practitioner - Otolaryngology 0941244677 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oxford Physical Therapy and RehabilitationGroup PAC ID 0244232874, 432 clinicians

Practice addresses (Care Compare)

2960 Mack Rd
Suite 200
Fairfield, OH 45014-5300
Phone (513) 860-5200

7567 Central Parke Blvd
Mason, OH 45040-6852

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
014566MEMDOtolaryngology Physician
38570MNMDOtolaryngology Physician
11025NDMDOtolaryngology Physician
35.152739OHMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Cincinnati Specialty Care LLC CurrentSince Apr 25, 2025 Accepting new patients
Southern Indiana ENT, LLC Otolaryngology CurrentSince Jun 17, 2024 Accepting new patients
Mercy Health Physicians Cincinnati Specialty Care LLC CurrentSince Apr 25, 2025 Accepting new patients
Scarborough Physical Therapy Associates, P.a. Past Accepting new patients
Maine Ear Nose & Throat Center LLC Otolaryngology PastSince Dec 21, 2000 Accepting new patients
Major Hospital Past Accepting new patients

Locations

1655 N Gladstone Ave
Ste E
Columbus, IN 47201
Phone (812) 376-3071

1701 Mercy Health Pl
Cincinnati, OH 45237
Phone (513) 952-5000

2960 Mack Rd
Ste 200
Fairfield, OH 45014
Phone (513) 860-5200

5470 Kings Island Dr
Ste 120
Mason, OH 45040
Phone (513) 791-4490

201 Old Bank Rd
Ste 103
Milford, OH 45150
Phone (513) 248-0100

Interoperability endpoints

  • Direct secure messaging: jay.raisen.1@12832.direct.athenahealth.com
  • Direct secure messaging: jraisen98294@edirect.chehr.org
  • Direct secure messaging: jay.raisen.1@15176.direct.athenahealth.com
  • Direct secure messaging: jraisen2843488@direct.bsmhealth.org
  • FHIR API: https://api.platform.athenahealth.com/12832/brand/1/csg/1/fhir/r4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1740305473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 MACK RD STE 200",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145300",
            "telephone_number": "513-860-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 MACK RD STE 200",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145300",
            "telephone_number": "513-860-5200",
            "fax_number": "513-860-5037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAISEN",
        "first_name": "JAY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "ME",
            "license": "014566",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "ND",
            "license": "11025",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MN",
            "license": "38570",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": "35.152739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

Verify at the official NPI Registry.