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

Individual provider Diagnostic Radiology Physician · NPI 1104844117

Dr. Raven Devincenzo, MD is a Diagnostic Radiology in Staten Island, New York. Graduated from State University of New York at Stony Brook, School of Medicine in 1998, 28 years ago. Practices with Holmdel Imaging LLC, a 4-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
28
Trained at
State University of New York at Stony Brook, School of Medicine
Licensed in
NY
In the registry since
2006
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

475 Seaview Ave
Staten Island, NY 10305-3436
Phone: (718) 226-9175
Fax: (718) 226-8198
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 217324 (NY)

Record details

NPI number1104844117
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 17, 2006
Last updated in NPPESJuly 9, 2007
Mailing addressPo Box 4652, Warren, NJ 07059-0652

Medicare enrollment

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

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolSTATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE
Graduated 1998 (28 years in practice)
Group practice Holmdel Imaging Llc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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