Individual provider Active NPI

Marc I Raphaelson, MD

  • Sleep Medicine (Internal Medicine) Physician
  • Leesburg, VA
National Provider Identifier
1841264413
Registry record updated Dec 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X
License
0101042614 Issued in VA
Practice address
525K East Market St
Leesburg, VA 20176
Phone
(703) 771-0274
Fax
(703) 771-0276
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2012

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 2084N0400X MD
Sleep Medicine (Internal Medicine) Physician 207RS0012X 0101042614 VA Primary
Sleep Medicine (Internal Medicine) Physician 207RS0012X 14958 WV
Sleep Medicine (Internal Medicine) Physician 207RS0012X D0026660 MD
Neurology Physician 2084N0400X 0101042614 VA

Addresses

Primary practice location

525K East Market St
Leesburg, VA 20176

Mailing address

525K East Market St
Box 326
Leesburg, VA 20176
Phone (703) 771-0274

Other identifiers 1

IdentifierTypeStateIssuer
13908 1300MedicaidMD

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0026660MDMDSleep Medicine (Internal Medicine) Physician
0101042614VAMDSleep Medicine (Internal Medicine) Physician
2084N0400XMDMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bioserenity DT Inc. Past Accepting new patients
Greater Washington Sleep Disorders Centers PastSince Oct 1, 2001 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355097600000",
    "number": "1841264413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525K EAST MARKET ST",
            "address_2": "BOX 326",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "20176",
            "telephone_number": "703-771-0274",
            "fax_number": "703-771-0276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525K EAST MARKET ST",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "20176",
            "telephone_number": "703-771-0274",
            "fax_number": "703-771-0276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAPHAELSON",
        "first_name": "MARC",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2012-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MD",
            "license": "2084N0400X",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "VA",
            "license": "0101042614",
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "WV",
            "license": "14958",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "MD",
            "license": "D0026660",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "VA",
            "license": "0101042614",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13908 1300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2012; 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.