RAPHAEL S. ORENSTEIN M.D.
NPI 1154306819
Physical Medicine & Rehabilitation in Durham, NC

NPI Status: Active since December 14, 2005

Contact Information

120 WILLIAM PENN PLZ
DURHAM, NC
ZIP 27704
Phone: (919) 220-5255
Fax: (919) 220-6971

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  • Individual
  • Male
  • Years of Experience 34
  • Physical Medicine & Rehabilitation
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About RAPHAEL ORENSTEIN

This page provides the complete NPI Profile along with additional information for Raphael Orenstein, a provider established in Durham, North Carolina with a medical specialization in Physical Medicine & Rehabilitation and more than 34 years of experience. He graduated from Emory University School Of Medicine in 1992. The healthcare provider is registered in the NPI registry with number 1154306819 assigned on December 2005. The practitioner's primary taxonomy code is 208100000X with license number 9701091 (NC). The provider is registered as an individual and his NPI record was last updated 18 years ago.

NPI
1154306819
Provider Name
RAPHAEL S. ORENSTEIN M.D.
Gender
Male
Entity Type
Individual
Location Address
120 WILLIAM PENN PLZ DURHAM, NC 27704
Location Phone
(919) 220-5255
Location Fax
(919) 220-6971
Mailing Address
120 WILLIAM PENN PLZ DURHAM, NC 27704
Mailing Phone
(919) 220-5255
Mailing Fax
(919) 220-6971
Medical School Name
EMORY UNIVERSITY SCHOOL OF MEDICINE
Graduation Year
1992
Is Sole Proprietor?
No
Enumeration Date
12-14-2005
Last Update Date
11-06-2007
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physical Medicine & Rehabilitation

Taxonomy Code
208100000X
Type
Allopathic & Osteopathic Physicians
License No.
9701091
License State
NC
Taxonomy Description
Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from conditions affecting the musculoskeletal system such as neck and back pain, sports injuries, or other painful conditions affecting the limbs, such as carpal tunnel syndrome. Alternatively, the disabilities may result from neurological trauma or disease such as spinal cord injury, head injury or stroke. A physician certified in physical medicine and rehabilitation is often called a physiatrist. The primary goal of the physiatrist is to achieve maximal restoration of physical, psychological, social and vocational function through comprehensive rehabilitation. Pain management is often an important part of the role of the physiatrist. For diagnosis and evaluation, a physiatrist may include the techniques of electromyography to supplement the standard history, physical, x-ray and laboratory examinations. The physiatrist has expertise in the appropriate use of therapeutic exercise, prosthetics (artificial limbs), orthotics and mechanical and electrical devices.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Blue Advantage Bronze Basic | 3 Free PCP | $20 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
  • Blue Advantage Bronze Complete | $60 PCP | $20 Tier 1 Rx | Nationwide Doctors - PPO
  • Blue Advantage Bronze Standard | Nationwide Doctors - PPO
  • Blue Advantage Gold Premier | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors - PPO
  • Blue Advantage Gold Standard | Nationwide Doctors - PPO
  • Blue Advantage Silver Choice | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors - PPO
  • Blue Advantage Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
  • Blue Advantage Silver Standard | Nationwide Doctors - PPO
  • Blue Care Bronze Standard | Statewide Doctors - HMO
  • Blue Care Gold Standard | Statewide Doctors - HMO
  • Blue Care Silver Standard | Statewide Doctors - HMO
  • Blue Home Bronze Basic | 3 Free PCP | $20 Tier 1 Rx | Integrated | with UNC Health Alliance - EPO
  • Blue Home Bronze Complete | $60 PCP | $20 Tier 1 Rx | with UNC Health Alliance - EPO
  • Blue Home Bronze Standard | with UNC Health Alliance - EPO
  • Blue Home Gold Premier | 3 Free PCP | $10 Tier 1 Rx | with UNC Health Alliance - EPO
  • Blue Home Gold Standard | with UNC Health Alliance - EPO
  • Blue Home Silver Choice | 3 Free PCP | $15 Tier 1 Rx | with UNC Health Alliance - EPO
  • Blue Home Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | with UNC Health Alliance - EPO
  • Blue Home Silver Standard | with UNC Health Alliance - EPO
  • Blue Value Bronze Basic | 3 Free PCP | $20 Tier 1 Rx | Integrated | Limited Statewide Doctors - POS
  • Connect Bronze 5500 Indiv Med Deductible - HMO
  • Connect Bronze 6500 Indiv Med Deductible - HMO
  • Connect Bronze CMS Standard - HMO
  • Connect Gold CMS Standard - HMO
  • Connect Silver 3500 Indiv Med Deductible - HMO
  • Connect Silver 4400 Indiv Med Deductible - HMO
  • Connect Silver CMS Standard - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
891072XMEDICAID (05)NC 
2244376AMEDICARE PIN (08)NC 
G24626MEDICARE UPIN (02)NC 

Medicare Participation & PECOS Enrollment Status

Raphael Orenstein is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Raphael Orenstein is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 2062507510

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20100624000741

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Follow-up hospital inpatient care per day, typically 25 minutes

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

This service was performed 544 times for 291 patients

Reviews for RAPHAEL S. ORENSTEIN M.D.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1154306819
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
21104601282
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 1 + 0 + 4 + 6 + 0 + 1 + 2 + 8 + 2 + 24 = 51
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 51 = 99

The NPI number 1154306819 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

WILLIAM JAMES MALLON M.D.

Orthopaedic Surgery

(Sports Medicine)

120 WILLIAM PENN PLZ
DURHAM, NC
ZIP 27704

(919) 220-5255

DAVID T DELLAERO M.D.

Orthopaedic Surgery

(Sports Medicine)

120 WILLIAM PENN PLZ
DURHAM, NC
ZIP 27704

(919) 220-5255

PETER W GILMER M.D.

Orthopaedic Surgery

120 WILLIAM PENN PLZ
DURHAM, NC
ZIP 27704

(919) 220-5255

RALPH A LIEBELT M.D.

Orthopaedic Surgery

120 WILLIAM PENN PLZ
DURHAM, NC
ZIP 27704

(919) 220-5255

EDWIN T. PRESTON M.D.

Orthopaedic Surgery

120 WILLIAM PENN PLZ
DURHAM, NC
ZIP 27704

(919) 220-5255

WILLIAM P. SILVER M.D.

Orthopaedic Surgery

(Sports Medicine)

120 WILLIAM PENN PLZ
DURHAM, NC
ZIP 27704

(919) 220-5255

KIRSTEN M. BIDDIX PA-C

Physician Assistant

120 WILLIAM PENN PLZ
DURHAM, NC
ZIP 27704

(919) 220-5255

SAMUEL T. DYER PA-C

Physician Assistant

120 WILLIAM PENN PLZ
DURHAM, NC
ZIP 27704

(919) 220-5255

RICHARD F BRUCH M.D.

Orthopaedic Surgery

120 WILLIAM PENN PLZ
DURHAM, NC
ZIP 27704

(919) 220-5255

RAJANI A. PATIL LPT

Physical Therapist

120 WILLIAM PENN PLZ
DURHAM, NC
ZIP 27704

(919) 220-5255

KEVIN M. LAVERY PA-C

Physician Assistant

120 WILLIAM PENN PLZ
DURHAM, NC
ZIP 27704

(919) 220-5255

NANCY N. BELDING LPT

Occupational Therapist

120 WILLIAM PENN PLZ
DURHAM, NC
ZIP 27704

(919) 220-5255

NICOLE HOLLY-CRICHLOW LPT

Physical Therapist

120 WILLIAM PENN PLZ
DURHAM, NC
ZIP 27704

(919) 220-5255

ELIZABETH W. JOHNSON LPT

Physical Therapist

120 WILLIAM PENN PLZ
DURHAM, NC
ZIP 27704

(919) 220-5255

CYNTHIA D. NELMS COVINGTON LPT

Physical Therapist

120 WILLIAM PENN PLZ
DURHAM, NC
ZIP 27704

(919) 220-5255

RITA A. SATTERFIELD LPT

Physical Therapist

120 WILLIAM PENN PLZ
DURHAM, NC
ZIP 27704

(919) 220-5255

SARAH E. SHOUT LPT

Physical Therapist

120 WILLIAM PENN PLZ
DURHAM, NC
ZIP 27704

(919) 220-5255

AARON THOMAS CIOTOLI P.T.

Physical Therapist

120 WILLIAM PENN PLZ
DURHAM, NC
ZIP 27704

(919) 220-5255

BETH MICHELE MARTIN MSOT

Occupational Therapist

120 WILLIAM PENN PLZ
DURHAM, NC
ZIP 27704

(919) 220-5255

SUSHIL RAMCHANDANI PT

Physical Therapist

120 WILLIAM PENN PLZ
DURHAM, NC
ZIP 27704

(919) 220-5255

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1154306819, enumerated as an "individual" on December 14, 2005.

The provider is located at 120 WILLIAM PENN PLZ DURHAM, NC 27704 and the phone number is (919) 220-5255.

Physical Medicine & Rehabilitation with taxonomy code 208100000X.

The provider might be accepting Accepts: Blue Cross and Blue Shield of NC, Cigna. Please consult your insurance carrier or call the provider to verify.