Individual provider Active NPI

Mayur Ramesh, MD

  • Infectious Disease Physician
  • Detroit, MI
National Provider Identifier
1043275167
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
4301067640 Issued in MI
Practice address
2799 W Grand Blvd
Henry Ford Health Systems
Detroit, MI 48202-2608
Phone
(313) 623-2531
Fax
(313) 916-2993
NPI assigned
Apr 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 4301067640 MI Primary

Addresses

Primary practice location

2799 W Grand Blvd
Henry Ford Health Systems
Detroit, MI 48202-2608

Mailing address

2799 W Grand Blvd
Henry Ford Health Systems
Detroit, MI 48202-2608
Phone (313) 623-2531

Other identifiers 3

IdentifierTypeStateIssuer
205365901MedicaidMO
473145OtherMOHEALTHLINK
144573OtherMOBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, MI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041213000020 MO Practitioner - Internal Medicine 7012974066 Reassigns benefits to 1 organization
I20091119000539 MI Practitioner - Infectious DiseasePractitioner - Internal Medicine 7012974066 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Health Center of Stoddard County LLC Internal Medicine CurrentSince Nov 26, 2018 Accepting new patients
Southeast Health Center of Stoddard County, LLC CurrentSince Nov 26, 2018 Accepting new patients
Southeast Health Center of Stoddard County, LLC Current Accepting new patients
Henry Ford Pathology Current Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients

Locations

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

2799 W Grand Blvd
#5
Detroit, MI 48202
Phone (313) 916-2710

1300 N One Mile Rd
Ste 7
Dexter, MO 63841
Phone (573) 624-3511

1300 N One Mile Rd
Ste 1
Dexter, MO 63841
Phone (573) 614-1971

1200 N One Mile Rd
Dexter, MO 63841
Phone (573) 614-1900

Interoperability endpoints

  • Direct secure messaging: mramesh14252@direct.hfhs.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1043275167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "address_2": "HENRY FORD HEALTH SYSTEMS",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-623-2531",
            "fax_number": "313-916-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "address_2": "HENRY FORD HEALTH SYSTEMS",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-623-2531",
            "fax_number": "313-916-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMESH",
        "first_name": "MAYUR",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MI",
            "license": "4301067640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205365901",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "473145",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "144573",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.