Individual provider Active NPI

Nader Elias Rayyan, MD

  • Internal Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1255185054
Registry record updated May 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4351053216 Issued in MI
Practice address
275 Michigan St NE
Grand Rapids, MI 49503
Phone
(616) 391-3777
NPI assigned
Apr 16, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4351053216 MI Primary

Addresses

Primary practice location

275 Michigan St NE
Grand Rapids, MI 49503

Mailing address

275 Michigan St NE
Grand Rapids, MI 49503

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240506004443 MI Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 8022458173

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1713225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779667200000",
    "number": "1255185054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49503",
            "telephone_number": "616-391-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYYAN",
        "first_name": "NADER",
        "middle_name": "ELIAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-16",
        "last_updated": "2026-05-25",
        "certification_date": "2026-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4351053216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.