RAQUEL FERNANDES
NPI 1003571878
Counselor - Mental Health in Coram, NY

Active since November 05, 2021Opted out of Medicare · through Nov 11, 2026
3600 ROUTE 112, CORAM, NY 11727(631) 920-8500 Get Directions Write a Review

NPPES record last updated: November 13, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 13, 2021, Nov 5, 2021 (2 updates tracked since 2021).

About Raquel Fernandes NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RAQUEL FERNANDES (NPI 1003571878) is an individual mental health provider in Coram, New York and active in the NPI registry since November 2021. She has opted out of Medicare through November 11, 2026.

NPPES Registry Identity

NPI1003571878
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameRAQUEL FERNANDES
Location Address3600 ROUTE 112Coram, NY 11727-4116
Mailing Address3600 Route 112Coram, NY 11727-4116 · (631) 920-8500
Sole ProprietorNo
Enumeration DateNovember 5, 2021
Last NPPES UpdateNovember 13, 20212 updates tracked since enumeration
NPPES CertifiedNovember 13, 2021
NPI 1003571878 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
3600 ROUTE 112, Coram, NY 11727

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Raquel Fernandes has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from November 11, 2024 through November 11, 2026.

Opt-Out Effective DateNovember 11, 2024
Opt-Out In Effect ThroughNovember 11, 2026Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Peer Specialist
3600 ROUTE 112
CORAM, NY 11727
Student in an Organized Health Care Education/Training Program
3600 ROUTE 112
CORAM, NY 11727
Day Training/Habilitation Specialist
3600 ROUTE 112
CORAM, NY 11727
Social Worker
3600 ROUTE 112
CORAM, NY 11727
Counselor (Mental Health)
3600 ROUTE 112
CORAM, NY 11727
Peer Specialist
3600 ROUTE 112
CORAM, NY 11727
Student in an Organized Health Care Education/Training Program
3600 ROUTE 112
CORAM, NY 11727
Case Manager/Care Coordinator
3600 ROUTE 112
CORAM, NY 11727

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Raquel Fernandes's NPI number?

The NPI number for Raquel Fernandes is 1003571878. It was assigned to this individual provider in the NPPES registry on November 5, 2021.

Where is Raquel Fernandes located?

Raquel Fernandes practices at 3600 Route 112, Coram, NY 11727. The listed phone number is (631) 920-8500.

What is Raquel Fernandes's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Raquel Fernandes enrolled in Medicare?

No. Raquel Fernandes has opted out of Medicare through November 11, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Raquel Fernandes was last updated on November 13, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.