MRS. DIANNE MARIE RAFFERTY (CRNP) – Women's Health Nurse Practitioner, NPI 1861474892

MRS. DIANNE MARIE RAFFERTY (CRNP) is a healthcare provider. based in Wickliffe, Ohio. specializing in Women's Health Nurse Practitioner. They hold the professional credentials CRNP. They hold a License No. RN155127 (OH). The NPI Number for MRS. DIANNE MARIE RAFFERTY (CRNP) is 1861474892

Main info

Female
24 Years Of Experience
Accepts Medicare Assignment
Name
MRS. DIANNE MARIE RAFFERTY (CRNP)
NPI
1861474892
Phone
(440) 944-0805
Address
2980 LEGEND LN
Enumeration Date
16 November 2005
Last Update Date
26 October 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4403520608
Graduation Year
2002 (24 years ago)
PAC ID
0446578025
Group Practice PAC ID
9032436068
Professional Enrollment ID
I20150410000488
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience58
Completeness75
Years active:20State licenses:2Digital endpointsOther names

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Provider Addresses for MRS. DIANNE MARIE RAFFERTY (CRNP)

  • 2980 LEGEND LN

    WICKLIFFE, OH 440922800

    Phone: (440) 944-0805

    Type: Mailing

  • 50,54,56, South State Street, Avery Terrace, Painesville, Lake County, Ohio, 44077, United States

    STE 203

    PAINESVILLE, OH 44077

    Phone: (440) 352-0608

    Fax: (440) 352-0640

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-01-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240113000354INurse PractitionerOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 44092)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9032436068View full group profile
NameSpecialtyState
-OH

Reviews

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Frequently asked questions

Is there an official ID for MRS. DIANNE MARIE RAFFERTY (CRNP) in U.S. healthcare records?
The official identifier for MRS. DIANNE MARIE RAFFERTY (CRNP) is NPI 1861474892.
Is MRS. DIANNE MARIE RAFFERTY (CRNP) still an active registrant?
MRS. DIANNE MARIE RAFFERTY (CRNP) carries an active NPI according to the public dataset.
What clinical focus is listed for MRS. DIANNE MARIE RAFFERTY (CRNP)?
At a glance, MRS. DIANNE MARIE RAFFERTY (CRNP) is tied to Women's Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is MRS. DIANNE MARIE RAFFERTY (CRNP) located near Wickliffe?
MRS. DIANNE MARIE RAFFERTY (CRNP) currently maps to Wickliffe, Ohio in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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