Revital Rahel Racin, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

258205 Issued in MA

Practice address

1180 Beacon St
Suite 7D
Brookline, MA 02446-3885

Phone

(617) 993-6100

Fax

(617) 993-6106

NPI assigned

Jun 15, 2009

Last updated

Oct 2, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Racinmd LLC

  • Child & Adolescent Psychiatry Physician
  • Brookline, MA
  • NPI 1154725141
  NPD (past) Authorized official

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

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412208000000",
    "number": "1790912905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 BEACON ST",
            "address_2": "SUITE 7D",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463885",
            "telephone_number": "617-993-6100",
            "fax_number": "617-993-6106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 BEACON ST",
            "address_2": "SUITE 7D",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463885",
            "telephone_number": "617-993-6100",
            "fax_number": "617-993-6106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACIN",
        "first_name": "REVITAL",
        "middle_name": "RAHEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-15",
        "last_updated": "2014-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MA",
            "license": "258205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Quinn, LCSW
• Thomas Mark Quinn, PHD
• Rebecca Judith Rabin
• Galina Rabkin, O.D.
• Jacob R Rachlin, M.D.
• Racinmd LLC
• Joseph L Raduazzo, M.D.
• Sadeq Rahimi, M.SC., PH.D.
• Erica Raine, MSW
• Malka Raisz, PT

• Child & Adolescent Psychiatry Physician in Brookline, MA
• Providers in Brookline, MA by specialty
• Child & Adolescent Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.