Individual provider Active NPI

Ramon Ray Gregorio Rayel, MD

  • Cardiovascular Disease Physician
  • Green Bay, WI
National Provider Identifier
1407828676
Registry record updated Apr 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
39472-020 Issued in WI
Practice address
2845 Greenbrier Rd Ste 310
Green Bay, WI 54311-6519
Phone
(920) 288-8300
Fax
(920) 288-8305
NPI assigned
Feb 2, 2006
Last updated
Apr 28, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 39472-020 WI Primary

Addresses

Primary practice location

2845 Greenbrier Rd Ste 310
Green Bay, WI 54311-6519

Mailing address

164 N Broadway
Green Bay, WI 54303-2728

Other identifiers 7

IdentifierTypeStateIssuer
32560500MedicaidWI
1042616OtherPREFERRED ONE
4657176MedicaidMI
P00188872OtherMIRAILROAD MEDICARE
0220121OtherMIBCBS OF MI
110B210270OtherMIBCBS
5206090MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20041021000027 WI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8123089398 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39472-020WIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Clinic LLP CurrentSince Jun 1, 2013 Accepting new patients
Baycare Clinic LLP Cardiovascular Disease CurrentSince Jun 1, 2013 Accepting new patients
Wisconsin Michigan Physicians, SC Past Accepting new patients

Locations

1721 S Stephenson Ave
Iron Mountain, MI 49801
Phone (906) 776-5415

1035 Kepler Dr
Green Bay, WI 54311

164 N Broadway
Green Bay, WI 54303
Phone (920) 965-4055

2253 W Mason St
Green Bay, WI 54303
Phone (920) 327-7000

2581 Development Dr
Green Bay, WI 54311
Phone (920) 347-0400

2845 Greenbrier Rd
Ste 310
Green Bay, WI 54311
Phone (920) 288-8300

3003 University Dr
Marinette, WI 54143
Phone (715) 732-8200

3100 Shore Dr
Ste 106
Marinette, WI 54143
Phone (715) 732-8230

3100 Shore Dr
Ste 111
Marinette, WI 54143
Phone (715) 732-8212

3130 Shore Dr
Marinette, WI 54143
Phone (715) 735-7421

719 Doctors Ct
Oshkosh, WI 54901
Phone (920) 235-0066

5000 Memorial Dr
Two Rivers, WI 54241
Phone (920) 794-5000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461801600000",
    "number": "1407828676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 N BROADWAY",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543032728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 GREENBRIER RD STE 310",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116519",
            "telephone_number": "920-288-8300",
            "fax_number": "920-288-8305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYEL",
        "first_name": "RAMON RAY",
        "middle_name": "GREGORIO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2016-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "39472-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32560500",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1042616",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4657176",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00188872",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI",
            "identifier": "0220121",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "110B210270",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5206090",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.