Active NPI
Raisa Yewah, MD
- Physical Medicine & Rehabilitation Physician
- Detroit, MI
National Provider Identifier
1043885924
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 4351049949
- Practice address
- 2799 W Grand Blvd
Detroit, MI 48202-2689 - Phone
- (313) 916-7134
- NPI assigned
- May 24, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 4351049949 | MI | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
2799 W Grand Blvd
Detroit, MI 48202-2689
Mailing address
2799 W Grand Blvd
Detroit, MI 48202-2689
Phone (313) 916-7134
Other practice location 1
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (248) 898-0161
Other practice location 2
420 E Superior St
Chicago, IL 60611-4494
Phone (312) 503-8194
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220627002974 | MI | Order and Referring Only - Physical Medicine and Rehabilitation | 6204215999 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4351049949 | MI | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782864000000",
"number": "1043885924",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2799 W GRAND BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482022689",
"telephone_number": "313-916-7134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2799 W GRAND BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482022689",
"telephone_number": "313-916-7134"
}
],
"practiceLocations": [
{
"address_1": "3601 W 13 Mile Rd",
"address_purpose": "LOCATION",
"city": "Royal Oak",
"state": "MI",
"postal_code": "480736712",
"country_code": "US",
"telephone_number": "248-898-0161",
"fax_number": "248-898-3631",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "420 E Superior St",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606114494",
"country_code": "US",
"telephone_number": "312-503-8194",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YEWAH",
"first_name": "RAISA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-24",
"last_updated": "2026-07-01",
"certification_date": "2026-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "MI",
"license": "4351049949",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.