Organization Active NPI

Rapha Medical LLC

  • Durable Medical Equipment & Medical Supplies
  • Tulsa, OK
National Provider Identifier
1780866079
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
RAPHA MEDICAL LLC
Practice address
4224 S Peoria Ave Ste 4
Tulsa, OK 74105-7640
Phone
(918) 270-4950
NPI assigned
Nov 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Authorized official

Name
Mr. Daniel S DickmanNPI 1851535926
Title
President/Owner
Phone
(405) 684-0729

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

4224 S Peoria Ave Ste 4
Tulsa, OK 74105-7640

Mailing address

4224 S Peoria Ave Ste 4
Tulsa, OK 74105-7640
Phone (918) 270-4950

Other practice location 1

10301 E 51st St Ste A
Tulsa, OK 74146-5808
Phone (918) 270-4950

Other identifiers 1

IdentifierTypeStateIssuer
200125610AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930079856 OK DME Supplier - Medical Supply CompanyDME Supplier - Medical Supply Company With Orthotic-ProstheticDME Supplier - Pedorthic Personnel 9133325731 Practice locations: Tulsa, OK

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Rapha Medical4224 S Peoria Ave, Tulsa, OK 74105-7640(918) 624-2185 Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom Does not accept assignmentParticipating since May 12, 2008

National Provider Directory

National Provider Directory

Locations

800 S 9th St
Ste A
Broken Arrow, OK 74012
Phone (717) 534-1300

10301 E 51st St
Ste A
Tulsa, OK 74146
Phone (918) 270-4950

4224 S Peoria Ave
Ste 4
Tulsa, OK 74105
Phone (405) 684-0729

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693180800000",
    "number": "1780866079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4224 S PEORIA AVE STE 4",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741057640",
            "telephone_number": "918-270-4950",
            "fax_number": "866-200-8489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4224 S PEORIA AVE STE 4",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741057640",
            "telephone_number": "918-270-4950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10301 E 51st St Ste A",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741465808",
            "country_code": "US",
            "telephone_number": "918-270-4950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RAPHA MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-29",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A",
        "authorized_official_last_name": "DICKMAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "405-684-0729",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200125610A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.