Individual provider Active NPI

Maya Shankaran Aravind, MD

  • Dermatology Physician
  • Ann Arbor, MI
National Provider Identifier
1245679661
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
4301508075 Issued in MI
Practice address
24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105-9484
Phone
(734) 936-4054
NPI assigned
Jun 19, 2013
Last updated
Jul 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 4301508075 MI Primary

Addresses

Primary practice location

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105-9484

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other identifiers 2

IdentifierTypeStateIssuer
Q032234MedicaidTN
6106418OtherBCBST

Other names 1

  • Maya Aravind Raiman Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mraiman789982@direct.sw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, 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
I20171219003198 TN Practitioner - Dermatology 1456660174 Reassigns benefits to 1 organization
I20221109001332 MI Practitioner - Dermatology 1456660174 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Michigan Medical School, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of MichiganGroup PAC ID 3779496856, shared by 45 NPIs, 3,344 clinicians

Practice addresses (Care Compare)

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000

1500 E Medical Ctr Dr 1St FL
Taubman Ctr Rec D
Ann Arbor, MI 48109-5000
Phone (734) 936-4185

1500 E Medical Ctr Dr 1St FL Rec D
Taubman Center
Ann Arbor, MI 48109-5000
Phone (734) 764-5175

1500 E Medical Ctr Dr 1St FL Rec F
Mott Hospital
Ann Arbor, MI 48109-5000
Phone (734) 764-5176

1500 E Medical Ctr Dr 3Rd FL Taubma
Ann Arbor, MI 48109-5000
Phone (734) 647-7321

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105-9484

7300 Dexter Ann Arbor Rd
Dexter, MI 48130-8598

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions368
Removal or shaving of skin growth1-10
Skin biopsy100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301508075MIMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Current Accepting new patients
Regents of the University of Michigan Dermatology CurrentSince Oct 11, 2022 Accepting new patients
Dermatology Associates of Oak Ridge,PC CurrentSince Oct 1, 2018 Accepting new patients
Regents of the University of Michigan CurrentSince Oct 11, 2022 Accepting new patients
Regents of the University of Michigan Past Accepting new patients

Locations

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

7500 Challis Rd
Brighton, MI 48116
Phone (734) 764-4190

7500 Challis Rd
Fl 2
Brighton, MI 48116
Phone (734) 647-5940

8001 Challis Rd
Brighton, MI 48116
Phone (810) 227-9510

599 Oak Ridge Tpke
Oak Ridge, TN 37830
Phone (865) 482-2129

Interoperability endpoints

  • Direct secure messaging: mraiman789982@direct.sw.org

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1245679661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-936-4054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARAVIND",
        "first_name": "MAYA",
        "middle_name": "SHANKARAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-19",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301508075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q032234",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST",
            "identifier": "6106418",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mraiman789982@direct.sw.org",
            "affiliation": "N",
            "address_1": "1700 University Dr E",
            "city": "College Station",
            "state": "TX",
            "country_code": "US",
            "postal_code": "778402661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MAYA",
            "last_name": "RAIMAN",
            "middle_name": "ARAVIND",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.