Active NPI
Raymond Robert Komray, M.D.
- Specialist
- Muskegon, MI
National Provider Identifier
1275553513
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Practice address
- 1365 Mercy Dr
Muskegon, MI 49444-1837 - Phone
- (231) 739-9095
- Fax
- (231) 739-6439
- NPI assigned
- Jul 20, 2006
- Last updated
- Mar 7, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | NU | Primary |
Addresses
Primary practice location
1365 Mercy Dr
Muskegon, MI 49444-1837
Mailing address
1365 Mercy Dr
Muskegon, MI 49444-1837
Phone (231) 739-9095
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0610450 | Other | MI | BCBS PROV ID NO |
| 1517752 | Medicaid | MI | |
| P55690 | Other | MI | BLUE CARE NETWORK PRO ID |
| 105115 | Other | MI | PREFERRED CHOICE PRO ID |
| RK039403 | Other | MI | BCBS REFERRING PRO ID NO. |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- raymond.komray.1@15079.direct.athenahealth.com
Organizations & group practices 1
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.
-
- Specialist
- Muskegon, MI
- NPI 1780883355
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1275553513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1365 MERCY DR",
"city": "MUSKEGON",
"state": "MI",
"postal_code": "494441837",
"telephone_number": "231-739-9095",
"fax_number": "231-739-6439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1365 MERCY DR",
"city": "MUSKEGON",
"state": "MI",
"postal_code": "494441837",
"telephone_number": "231-739-9095",
"fax_number": "231-739-6439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOMRAY",
"first_name": "RAYMOND",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-20",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROV ID NO",
"identifier": "0610450",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1517752",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CARE NETWORK PRO ID",
"identifier": "P55690",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CHOICE PRO ID",
"identifier": "105115",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS REFERRING PRO ID NO.",
"identifier": "RK039403",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Muskegon, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.