Raynold Depestre, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D27157 Issued in MD

Practice address

3704 Lanamer Rd
Randallstown, MD 21133-1517

Phone

(410) 265-5400

Fax

(410) 298-3917

NPI assigned

Sep 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1831291285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3704 LANAMER RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "21133",
            "telephone_number": "410-655-4946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3704 LANAMER RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211331517",
            "telephone_number": "410-265-5400",
            "fax_number": "410-298-3917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPESTRE",
        "first_name": "RAYNOLD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D27157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "484691500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Oluwaseun Davies, MD
• Paula Gemmil Davis, MSW
• Daylight Healthcare Services, Inc
• Pierre Guy Daze, MSHS, PA-C
• Michael De Wit, M.D.
• Roger L Deshong, PA
• Destilee Health Care
• Mike Destine
• Julija Jael Devance
• Dharani Jasthi DMD PC

• Internal Medicine Physician in Randallstown, MD
• Providers in Randallstown, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.