NPIMap

Individual provider Active NPI

Jonathan L Raanan, MD

  • Physical Medicine & Rehabilitation Physician
  • East Setauket, NY
National Provider Identifier
1790754976
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
226609-1 Issued in NY
Practice address
24 Research Way
Suite 200
East Setauket, NY 11733-3453
Phone
(631) 444-1210
Fax
(631) 444-1535
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 226609-1 NY Primary

Addresses

Primary practice location

24 Research Way
Suite 200
East Setauket, NY 11733-3453

Mailing address

24 Research Way
Suite 200
East Setauket, NY 11733-3453
Phone (631) 444-1210

Other identifiers 1

IdentifierTypeStateIssuer
0361131251MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060918000496 NY Practitioner - Physical Medicine and Rehabilitation 8426086364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Rutgers New Jersey Medical School, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Lauterbur Dr
Stony Brook Cancer Center
Stony Brook, NY 11794-0001
Phone (631) 444-1213

100 Nicolls Rd
Stony Brook, NY 11794-8122
Phone (631) 444-1213

101 Nicolls Rd
Stony Brook, NY 11794-8122
Phone (631) 444-1213

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
226609-1NYMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York Spine & Brain Surgery, University Faculty Practice Corporatio CurrentSince Sep 5, 2006 Accepting new patients
Neurology Associates of Stony Brook, University Faculty Practice Corpo Past Accepting new patients
Chicago Institute of Neurosurgery & Neuroresearch Past Accepting new patients

Locations

23 S Howell Ave
Ste G
Centereach, NY 11720
Phone (631) 638-1279

24 Research Way
Ste 200
East Setauket, NY 11733
Phone (631) 444-1210

54 Commerce Ave
Ste 7
Riverhead, NY 11901
Phone (631) 444-1210

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Networks

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

Interoperability endpoints

  • Direct secure messaging: jonathan.raanan@direct.stonybrookmedicine.edu

Organizations & group practices 3

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 8

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": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790754976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 RESEARCH WAY",
            "address_2": "SUITE 200",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333453",
            "telephone_number": "631-444-1210",
            "fax_number": "631-444-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 RESEARCH WAY",
            "address_2": "SUITE 200",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333453",
            "telephone_number": "631-444-1210",
            "fax_number": "631-444-1535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAANAN",
        "first_name": "JONATHAN",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "226609-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0361131251",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.