Raffi Djevalikian, M.D.
Individual provider Active NPI Family Medicine Physician · Henryetta, OK
NPI 1992749121 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1992749121
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 22166 (OK)
- Practice address
- Dewey Bartlett & Main
Henryetta, OK 74437 - Phone
- (918) 650-1301
- Fax
- (918) 650-0568
- NPI assigned
- Jun 16, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- San Joaquin Emergency Medical Associates
Practice addresses (Care Compare)
333 Mercy Ave
Merced, CA 95340-8319
Phone (209) 564-5140
Hospital & facility affiliations
- Mercy Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- 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 |
|---|---|---|---|---|
| I20071023000351 | CA | Practitioner - Family Practice |
4688628910 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 78701 | CA | MD | Clinical Social Worker |
| 22160 | OK | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Joaquin Emergency Medical Associates | Current |
Accepting new patients | |
| Satwant Tandon MD PC | Past | Accepting new patients | |
| Ahs Oklahoma Physician Group LLC | Family Medicine | Past | Accepting new patients |
Locations
333 Mercy Ave
Merced, CA 95340
Phone (209) 385-1280
Interoperability endpoints
- https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 22166 | OK | Yes |
Addresses
Primary practice location
Dewey Bartlett & Main
Henryetta, OK 74437
Mailing address
PO Box 1269
Henryetta, OK 74437-1269
Phone (918) 650-1301
Other providers in Henryetta, OK
- Brawna Chowins
- Country Style Health Care Inc IX
- Michele Diane Crawley
- Chereeka Antonnia Darling
- Kelley Anne Davidson
- East Central Oklahoma Family Health Center, Inc.
- East Central Oklahoma Family Health Center, Inc.
- Eidetik of Weleekta, L.L.C.
- Eidetik of Weleetka
- Eidetik of Weleetka, LLC
All providers in Henryetta, OK · Family Medicine Physician in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. 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.