Active NPI
Rebecca Raoof, MD
- Pediatrics Physician
- Brooklyn, NY
National Provider Identifier
1790881027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 128062
- Practice address
- 1390 Pennsylvania Ave
Brooklyn, NY 11239-2103 - Phone
- (718) 642-9855
- NPI assigned
- Sep 15, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 128062 | NY | Primary |
Addresses
Primary practice location
1390 Pennsylvania Ave
Brooklyn, NY 11239-2103
Mailing address
14 Pheasant Hill LN
Glen Head, NY 11545-2115
Phone (516) 671-7582
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00237518 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 128062 | NY | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790881027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 PHEASANT HILL LN",
"city": "GLEN HEAD",
"state": "NY",
"postal_code": "115452115",
"telephone_number": "516-671-7582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1390 PENNSYLVANIA AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112392103",
"telephone_number": "718-642-9855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAOOF",
"first_name": "REBECCA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "128062",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00237518",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.