Organization Active NPI

Ray Pastor DO PC

  • Surgery Physician
  • Farmington Hills, MI
National Provider Identifier
1063256576
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
RAY PASTOR DO PC
Practice address
28080 Grand River Ave Ste 204N
Farmington Hills, MI 48336-5966
Phone
(248) 478-7767
Fax
(248) 478-5727
NPI assigned
Jun 20, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Authorized official

Name
Raimundo Pastor, DONPI 1780796078
Title
President
Phone
(248) 478-7767

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

28080 Grand River Ave Ste 204N
Farmington Hills, MI 48336-5966

Mailing address

28080 Grand River Ave Ste 204
Farmington Hills, MI 48336-5966
Phone (248) 478-7767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241023000535 MI Part B Supplier - Clinic/Group Practice 4486187911 Receives reassigned benefits from 3 practitioners
Practice locations: Farmington Hills, MI

National Provider Directory

National Provider Directory

Locations

28080 Grand River Ave
Ste 204
Farmington Hills, MI 48336
Phone (248) 478-7767

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1718841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729123200000",
    "number": "1063256576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28080 GRAND RIVER AVE STE 204",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483365966",
            "telephone_number": "248-478-7767",
            "fax_number": "248-478-5727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28080 GRAND RIVER AVE STE 204N",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483365966",
            "telephone_number": "248-478-7767",
            "fax_number": "248-478-5727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAY PASTOR DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A",
        "authorized_official_last_name": "PASTOR",
        "authorized_official_first_name": "RAIMUNDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-478-7767",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.