Raul Johan Poulsen, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A173593 Issued in CA

Practice address

300 Pasteur Dr
Stanford, CA 94305-2200

Phone

(650) 723-4000

NPI assigned

Aug 2, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, CA2 enrollments

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 2

Specialty

Psychiatry

Education

University of Puerto Rico School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Momentum for HealthGroup PAC ID 2769377217, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Santa Clara Valley Medical Center Hospital, San Jose, CA, CCN 050038

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Momentum for Health

  • Community/Behavioral Health Agency
  • San Jose, CA
  • NPI 1154426807
  Medicare reassignment Care Compare group NPD
• County of Santa Clara

  • Anesthesiology Physician
  • San Jose, CA
  • NPI 1588721500

  Child & Adolescent Psychiatry

  Medicare reassignment NPD
• County of Santa Clara

  • Federally Qualified Health Center (FQHC)
  • San Jose, CA
  • NPI 1629301346
  Medicare reassignment NPD
• County of Santa Clara

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Jose, CA
  • NPI 1699885079
  Medicare reassignment NPD
• LPCH Medical Group Div of Lucile

  • Children's Hospital
  • Palo Alto, CA
  • NPI 1417907940
  Medicare reassignment NPD
• Stanford Health Care

  • General Acute Care Hospital
  • Stanford, CA
  • NPI 1437292927
  Medicare reassignment NPD
• University of Miami

  • Hepatology Physician
  • Miami, FL
  • NPI 1013967827
  Medicare reassignment NPD
• County of Santa Clara

  • Federally Qualified Health Center (FQHC)
  • San Jose, CA
  • NPI 1043354020
  NPD
• County of Santa Clara

  • Pharmacy
  • San Jose, CA
  • NPI 1891871919
  NPD
• County of Santa Clara

  • Federally Qualified Health Center (FQHC)
  • San Jose, CA
  • NPI 1972598449
  NPD
• Momentum for Health

  • Psychologist
  • San Jose, CA
  • NPI 1760181234
  NPD
• Momentum for Health

  • Psychologist
  • San Jose, CA
  • NPI 1922300128
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• County of Santa Clara

  • General Acute Care Hospital
  • San Jose, CA
  • NPI 1063406551
  Care Compare affiliation

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

{
    "created_epoch": "1375401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1962834812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1695 NW 9th Ave Ofc 1401",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361409",
            "country_code": "US",
            "telephone_number": "305-355-7080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POULSEN",
        "first_name": "RAUL",
        "middle_name": "JOHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-02",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME132590",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A173593",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A173593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sofia Elena Posada, PA-C
• Lisa Imbrogulio Post, PHD
• Kathleen Lombard Poston, M.D.
• Vijay Raveendran Pottathil, M.D.
• Peter Dean Poullos, M.D.
• Alexandra Lynn Pourzia, MD
• May Nguyen Powell, NP
• Anthonette Cossio Poyotte, NP
• Kris Prado, MD
• Bhavana Prakash, PA

• Psychiatry Physician in Stanford, CA
• Providers in Stanford, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.