Tom David Raisanen, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

4301110056 Issued in MI

Practice address

205 Osceola St
Laurium, MI 49913-2134

Phone

(906) 337-6560

NPI assigned

Apr 2, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aspirus KeweenawGroup PAC ID 8123912011, shared by 7 NPIs, 116 clinicians

Aspirus Ironwood Hospital and Clinics IncGroup PAC ID 9032013198, 165 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aspirus Keweenaw Hospital and Clinics Hospital, Laurium, MI, CCN 231319

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: traisanen154841@direct.aspirus.org

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

• Aspirus Ironwood Hospital & Clinics, Inc.

  • Family Medicine Physician
  • Ironwood, MI
  • NPI 1992704753
  Medicare reassignment Care Compare group NPD
• Aspirus Iron River Hospital & Clinics, Inc.

  • Critical Access Hospital
  • Iron River, MI
  • NPI 1497750830
  Medicare reassignment NPD
• Aspirus Ironwood Hospital & Clinics, Inc.

  • Critical Access Hospital
  • Ironwood, MI
  • NPI 1649297342
  Medicare reassignment NPD
• Aspirus Keweenaw

  • Rural Health Clinic/Center
  • Laurium, MI
  • NPI 1205998713
  Medicare reassignment NPD
• Aspirus Keweenaw

  • Critical Access Hospital
  • Laurium, MI
  • NPI 1326115569
  Medicare reassignment NPD
• Aspirus Iron River Hospital & Clinics, Inc.

  • Rural Health Clinic/Center
  • Iron River, MI
  • NPI 1306344783
  NPD
• Aspirus Iron River Hospital & Clinics, Inc.

  • Multi-Specialty Clinic/Center
  • Iron River, MI
  • NPI 1457865198
  NPD
• Aspirus Ironwood Hospital & Clinics, Inc.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Ironwood, MI
  • NPI 1609743590
  NPD
• Aspirus Keweenaw

  • Rural Health Clinic/Center
  • Ontonagon, MI
  • NPI 1023161932
  NPD
• Aspirus Keweenaw

  • Rural Health Clinic/Center
  • Houghton, MI
  • NPI 1215092572
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Aspirus Keweenaw

  • Rural Health Clinic/Center
  • Ontonagon, MI
  • NPI 1023161932

  Hospital

  Care Compare affiliation
• Aspirus Keweenaw

  • Pharmacy
  • Ontonagon, MI
  • NPI 1104516376

  Hospital

  Care Compare affiliation
• Aspirus Keweenaw

  • Critical Access Hospital
  • Laurium, MI
  • NPI 1326115569
  Care Compare affiliation

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

{
    "created_epoch": "1459555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1124481544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50384 ROCKY SHORES RD",
            "city": "HOUGHTON",
            "state": "MI",
            "postal_code": "499319213",
            "telephone_number": "320-267-4247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 OSCEOLA ST",
            "city": "LAURIUM",
            "state": "MI",
            "postal_code": "499132134",
            "telephone_number": "906-337-6560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAISANEN",
        "first_name": "TOM",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-02",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301110056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clint Pakkala, NP
• Larisa Pavlovna Petrova-Pollard, MASSAGE THERAPIST
• Laura Polakowski
• Leah Polzien, D.C.
• Richard John Raffaelli, PA-C
• Frederick D Rau, MD
• Sally D. Orr, D.D.S., P.C.
• Sharon A Stoll, M.D.
• Lauren Nichole Tanskanen, OTR
• Aaron S Tragos, DO

• Dermatology Physician in Laurium, MI
• Providers in Laurium, MI by specialty
• Dermatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.