Individual provider Active NPI

Gurmukh S Raince, M.D.

  • Family Medicine Physician
  • South Richmond Hill, NY
National Provider Identifier
1942227509
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
163741 Issued in NY
Practice address
11407 101St Ave
South Richmond Hill, NY 11419-1138
Phone
(718) 805-1358
Fax
(718) 805-6911
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 163741 NY Primary

Addresses

Primary practice location

11407 101St Ave
South Richmond Hill, NY 11419-1138

Mailing address

11407 101St Ave
South Richmond Hill, NY 11419-1138
Phone (718) 805-1358

Other identifiers 1

IdentifierTypeStateIssuer
0918305MedicaidNY

Other names 1

  • Dr. Gurmukh S Raince Professional name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120130000800 NY Practitioner - Family PracticePractitioner - Pediatric Medicine 4486811668 Practice locations: Richmond Hill, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Cardiology Consultants, PLLC Past Accepting new patients

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942227509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11407 101ST AVE",
            "city": "SOUTH RICHMOND HILL",
            "state": "NY",
            "postal_code": "114191138",
            "telephone_number": "718-805-1358",
            "fax_number": "718-805-6911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11407 101ST AVE",
            "city": "SOUTH RICHMOND HILL",
            "state": "NY",
            "postal_code": "114191138",
            "telephone_number": "718-805-1358",
            "fax_number": "718-805-6911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAINCE",
        "first_name": "GURMUKH",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "163741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0918305",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GURMUKH",
            "last_name": "RAINCE",
            "middle_name": "S",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in South Richmond Hill, NY

Sources for this page

Verify at the official NPI Registry.