MEDICARE: ANTHONY JAY RAIMONDE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0102X	Surgical Critical Care Physician	35.058176	OH
2	208600000X	Surgery Physician	35-058176	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	00408879	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000502923	OTHER		ANTHEM
3	34-1742589	OTHER		SUMMA
4	4569518	OTHER		AETNA
5	01343	OTHER		PARAMOUNT
6	732320	OTHER		BUCKEYE COMMUNITY HEALTH PLAN
7	000000315352	OTHER	OH	ANTHEM
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	6683114	OTHER		CIGNA
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396745410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY JAY RAIMONDE MD

Provider Business Mailing Address
First Line	:	2213 CHERRY ST STE ACC 200
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43608-2603
Country	:	US
Telephone Number	:	419-251-4283
Fax Number	:	419-251-0814

Provider Business Practice Location Address
First Line	:	2213 CHERRY ST STE ACC 200
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43608-2603
Country	:	US
Telephone Number	:	419-251-4283
Fax Number	:	419-251-0814

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	09/27/2019

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