Jeremy Steven Raab, M.D.
Individual provider Active NPI Family Medicine Physician · Tamuning, GU
NPI 1992067474 · NPPES record last updated May 26, 2020
Key facts
- NPI
- 1992067474
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- M-2165 (GU)
- Practice address
- 1244 N Marine Corps Dr
Tamuning, GU 96913-4308 - Phone
- (671) 647-8262
- NPI assigned
- Jun 11, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Eastern Virginia Medical School, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- American Medical Center, LLC
Practice addresses (Care Compare)
1244 N Marine Corps Dr
Tamuning, GU 96913
Phone (671) 647-8262
1244 N Marine Corps Dr
Tamuning, GU 96913-4308
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GU
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191115002909 | GU | Practitioner - Family Practice | 8921231374 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0116024649 | VA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Medical Center, LLC | Current |
Accepting new patients |
Locations
1244 N Marine Corps Dr
Tamuning, GU 96913
Phone (671) 647-8262
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0116024649 | VA | |
| Family Medicine Physician | 207Q00000X | M-2165 | GU | Yes |
Addresses
Primary practice location
1244 N Marine Corps Dr
Tamuning, GU 96913-4308
Mailing address
1244 N Marine Corps Dr
Tamuning, GU 96913-4308
Phone (671) 647-8262
Other practice location 1
9300 DeWitt Loop
Family Medicine Residency
Fort Belvoir, VA 22060-5285
Phone (571) 231-2356
Other providers in Tamuning, GU
- Priority One Transport LLC
- Danica Grace Laborte Pua
- Celeste Ulanday Punzalan-Almira
- Bannuar Emmanuel Tomboc Quiaoit
- Sylvia T Quinata
- Carlo Rada
- Richelle Rada
- Kirstin Maree Anderson Raguindin
- Kia M Rahmani
- Gia Stella B Ramos
All providers in Tamuning, GU · Family Medicine Physician in Guam
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 26, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.