DR. BRAD RAPHAEL (NPI# 1295992303) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295992303 |
| Entity Type | Individual |
| Full Name | DR. BRAD RAPHAEL |
| Credential | M.D. |
| Practice Address |
5719 Widewaters Pkwy Syracuse NY 13214-1985 |
| Mailing Address |
5824 Widewaters Pkwy East Syracuse NY 13057-3072 |
| Practice Telephone | 3152513100 |
| Practice Fax Number | 3154499923 |
| Mailing Telephone | 3152513105 |
| Enumeration Date | 2008-05-18 |
| Last Update Date | 2018-04-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | 240654 | NY | Allopathic & Osteopathic Physicians |
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
240654 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03371322 | 05 |
| Street Address |
5719 WIDEWATERS PKWY |
| City | SYRACUSE |
| State | NY |
| Zip Code | 13214-1985 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871598805 | Michael T Clarke | Orthopaedic Surgery | 5719 Widewaters Pkwy, Syracuse, NY 13214-1880 | 2005-06-16 |
| 1700486065 | Heather M. Stamour | Nurse Practitioner | 5719 Widewaters Pkwy, Syracuse, NY 13214-1985 | 2020-10-27 |
| 1962062364 | Onondaga Orthopedics LLP | Durable Medical Equipment & Medical Supplies | 5719 Widewaters Pkwy, Syracuse, NY 13214-1985 | 2019-06-18 |
| 1548711583 | Laura Yasuko Goodwell-velez | Specialist/Technologist | 5719 Widewaters Pkwy, Syracuse, NY 13214-1985 | 2016-10-14 |
| 1811448855 | Laurance Goodwin IIi | Specialist/Technologist | 5719 Widewaters Pkwy, Syracuse, NY 13214-1985 | 2016-10-14 |
| 1326486754 | Nicole I. Jones | Physician Assistant | 5719 Widewaters Pkwy, Syracuse, NY 13214-1985 | 2013-06-07 |
| 1821330176 | Anthony M Orio | Orthopaedic Surgery | 5719 Widewaters Pkwy, Syracuse, NY 13214-1985 | 2013-03-25 |
| 1790036697 | Marvin Balmir | Physician Assistant | 5719 Widewaters Pkwy, Syracuse, NY 13214-1985 | 2012-10-02 |
| 1295093763 | Cassandra Riggs | Orthopaedic Surgery | 5719 Widewaters Pkwy, Syracuse, NY 13214 | 2012-05-02 |
| 1275845760 | Melissa A Cullinan | Physician Assistant | 5719 Widewaters Pkwy, Syracuse, NY 13214-1877 | 2010-07-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881108983 | Nathan Fowler | Dentist | 3469 Erie Blvd E # 3a, Syracuse, NY 13214 | 2017-11-28 |
| 1841716875 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3649 Erie Blvd E Ste 215b, Syracuse, NY 13214 | 2017-08-22 |
| 1124568993 | Jose Alvarez | Dentist | 3425 Erie Blvd E Ste 1, De Witt, NY 13214 | 2017-02-27 |
| 1205258365 | Margaret Miller | Social Worker | 4101 E. Genesee St, Syracuse, NY 13214 | 2014-01-09 |
| 1124367669 | Marni Marie Millet | Counselor | 4309 E Genesee St Ste 4, Syracuse, NY 13214 | 2013-02-04 |
| 1477817401 | Runa Acharya | Internal Medicine | 3229 East Genesee St, Syracuse, NY 13214 | 2012-06-25 |
| 1487949913 | Angela Patricia Mojica Sanabria | Pediatrics | 3229 East Genesee St Ste 1, Syracuse, NY 13214 | 2011-06-13 |
| 1346530169 | Affinity Rehabilitation LLP | Clinic/Center | 18 Arbor Lane, Dewitt, NY 13214 | 2011-04-13 |
| 1003105768 | David William Hansen | Pediatrics | 3229 E. Genesee St, Suite 1, Syracuse, NY 13214 | 2011-04-04 |
| 1558676411 | Jamesville-dewitt Central School District | Local Education Agency (LEA) | Edinger Drive, Dewitt, NY 13214 | 2010-08-16 |
| Find all providers in zip 13214 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437142346 | Cny Orthopedic Sports Medicine PC | Orthopaedic Surgery | 2200 E Genesee St, Syracuse, NY 13210-2253 | 2005-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063057347 | Viorika Chebotaru | Orthopaedic Surgery | 626 Sheepshead Bay Rd, Brooklyn, NY 11224-3602 | 2019-11-11 |
| 1609421122 | Mulchandani Medical Pllc | Orthopaedic Surgery | 139 Centre St Lbby Suite102, New York, NY 10013-4552 | 2019-08-02 |
| 1891258349 | Empire Ny Orthopedics PC | Orthopaedic Surgery | 22215 Northern Blvd Ste Lobbya, Bayside, NY 11361-3678 | 2019-04-11 |
| 1821566688 | Chelsea Rose Weir | Orthopaedic Surgery | 379 Oakwood Rd Ste C, Huntington Station, NY 11746-7203 | 2018-11-08 |
| 1578046421 | Djf Orthopedics and Sports Medicine | Orthopaedic Surgery | 165 W End Ave Apt 28p, New York, NY 10023-5516 | 2018-09-06 |
| 1992201222 | Scott Adam Weiss Md PC | Orthopaedic Surgery | 672 Harless Pl, West Hempstead, NY 11552-3504 | 2018-04-04 |
| 1467965095 | Melissa Pei-lih Mau | Orthopaedic Surgery | 2800 Marcus Ave Ste 102, New Hyde Park, NY 11042-1113 | 2017-11-06 |
| 1821476698 | Stephanie M Macdonald | Orthopaedic Surgery | 1672 Empire Blvd Ste 100, Webster, NY 14580-2199 | 2015-05-13 |
| 1710380118 | Stony Brook University | Orthopaedic Surgery | Toll Dr Bldg 39, Stony Brook, NY 11794-0001 | 2014-09-30 |
| 1083029623 | Michael J. Katz Md PC | Orthopaedic Surgery | 14653 Delaware Ave, Flushing, NY 11355-2182 | 2014-06-23 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.