Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Raphael Bollag, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1629463708

Dr. Raphael Bollag, MD is an Emergency Medicine in Bay Shore, New York. Qualified in 2015, 11 years ago. Practices with North Shore-Lij Medical PC, a 6,350-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New York.

Years since qualifying
11
Licensed in
NY
In the registry since
2015
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

301 E Main St
Bay Shore, NY 11706-8408
Phone: (631) 968-3000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 300 Community Dr, Manhasset, NY 11030-3816 — (516) 562-0100

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 295389 (NY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1629463708
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 5, 2015
Last updated in NPPESJuly 20, 2021
Certification dateJuly 20, 2021
Mailing address301 E Main St, Bay Shore, NY 11706-8408

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice North Shore-Lij Medical Pc — 6350 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Bay Shore