Individual provider Active NPI

Caroline M Raftopol, PA-C

  • Medical Physician Assistant
  • Fishkill, NY
National Provider Identifier
1881969004
Registry record updated Dec 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
015522 Issued in NY
Practice address
969 Main St Ste D
Fishkill, NY 12524-1791
Phone
(845) 896-7730
Fax
(845) 896-0273
NPI assigned
Mar 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 015522 NY Primary

Addresses

Primary practice location

969 Main St Ste D
Fishkill, NY 12524-1791

Mailing address

969 Main St Ste D
Fishkill, NY 12524-1791
Phone (845) 896-7730

Other practice location 1

336 Route 202 Ste 2
Somers, NY 10589-3221
Phone (914) 617-8950

Other practice location 2

155 White Plains Rd Ste 109
Tarrytown, NY 10591-5563
Phone (914) 829-8200

Other identifiers 1

IdentifierTypeStateIssuer
04964307MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120327000365 NY Practitioner - Physician Assistant 4284894429 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 1

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": "1332288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544659200000",
    "number": "1881969004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "969 MAIN ST STE D",
            "city": "FISHKILL",
            "state": "NY",
            "postal_code": "125241791",
            "telephone_number": "845-896-7730",
            "fax_number": "845-896-0273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 MAIN ST STE D",
            "city": "FISHKILL",
            "state": "NY",
            "postal_code": "125241791",
            "telephone_number": "845-896-7730",
            "fax_number": "845-896-0273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "336 Route 202 Ste 2",
            "address_purpose": "LOCATION",
            "city": "Somers",
            "state": "NY",
            "postal_code": "105893221",
            "country_code": "US",
            "telephone_number": "914-617-8950",
            "fax_number": "914-617-8960",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "155 White Plains Rd Ste 109",
            "address_purpose": "LOCATION",
            "city": "Tarrytown",
            "state": "NY",
            "postal_code": "105915563",
            "country_code": "US",
            "telephone_number": "914-829-8200",
            "fax_number": "914-829-8201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAFTOPOL",
        "first_name": "CAROLINE",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-21",
        "last_updated": "2018-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "015522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04964307",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishkill, NY

Sources for this page

Verify at the official NPI Registry.