Individual provider Active NPI

Philip Rufus Raiford, M.D.

  • Family Medicine Physician
  • Danielson, CT
National Provider Identifier
1962487983
Registry record updated Jan 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
031486 Issued in CT
Practice address
45 Green Hollow Rd
Danielson, CT 06239-3509
Phone
(860) 774-1255
Fax
(860) 779-2059
NPI assigned
Dec 13, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2008

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 031486 CT Primary

Addresses

Primary practice location

45 Green Hollow Rd
Danielson, CT 06239-3509

Mailing address

45 Green Hollow Rd
Danielson, CT 06239-3509
Phone (860) 774-1255

Other identifiers 1

IdentifierTypeStateIssuer
001314864MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20080731000057 CT Practitioner - Family PracticePractitioner - General Surgery 0648344275 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
031486CTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ipc Hospitalists of New England, P.C. Family Medicine Current Accepting new patients
Ipc Hospitalists of New England PC Family Medicine CurrentSince Sep 12, 2018 Accepting new patients
Ipc Hospitalists of New England, P.C. Family Medicine CurrentSince Sep 12, 2018 Accepting new patients

Locations

23 Fair St
Bristol, CT 06010
Phone (860) 347-6300

169 Davenport Ave
New Haven, CT 06519
Phone (203) 789-1650

365 Montauk Ave
New London, CT 06320
Phone (860) 271-4364

31 Vauxhall St
New London, CT 06320
Phone (203) 789-1650

88 Clark Ln
Waterford, CT 06385
Phone (860) 442-0471

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": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201219200000",
    "number": "1962487983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 GREEN HOLLOW RD",
            "city": "DANIELSON",
            "state": "CT",
            "postal_code": "062393509",
            "telephone_number": "860-774-1255",
            "fax_number": "860-779-2059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 GREEN HOLLOW RD",
            "city": "DANIELSON",
            "state": "CT",
            "postal_code": "062393509",
            "telephone_number": "860-774-1255",
            "fax_number": "860-779-2059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAIFORD",
        "first_name": "PHILIP",
        "middle_name": "RUFUS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2008-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "031486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001314864",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danielson, CT

Sources for this page

Verify at the official NPI Registry.