Individual provider Active NPI

Gary Benjamin Rajah II, M.D

  • Neurological Surgery Physician
  • Detroit, MI
National Provider Identifier
1457616849
Registry record updated Apr 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
4301101109 Issued in MI
Practice address
4201 Saint Antoine St
6E DRH
Detroit, MI 48201-2153
Phone
(313) 745-4523
NPI assigned
Jul 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 4301101109 MI Primary

Addresses

Primary practice location

4201 Saint Antoine St
6E DRH
Detroit, MI 48201-2153

Mailing address

1221 Sixth St Ste 300
Traverse City, MI 49684-2360
Phone (231) 392-0640

Other practice location 1

1221 Sixth St Ste 300
Traverse City, MI 49684-2360
Phone (231) 392-0640

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Gary.rajah@gts.eclinicaldirectplus.com

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
I20200511002776 MI Practitioner - Neurosurgery 4981905676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Wayne State University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Munson Medical CenterGroup PAC ID 3072426287, 377 clinicians

Practice addresses (Care Compare)

1221 6TH St
Traverse City, MI 49684-2701
Phone (231) 392-0643

Hospital & facility affiliations

  • Munson Medical Center Hospital, Traverse City, MI, CCN 230097
  • Munson Healthcare Cadillac Hospital Hospital, Cadillac, MI, CCN 230081
  • Munson Healthcare Otsego Memorial Hospital Hospital, Gaylord, MI, CCN 230133
  • Munson Healthcare Manistee Hospital Hospital, Manistee, MI, CCN 230303
  • Charlevoix Area Hospital Hospital, Charlevoix, MI, CCN 231322

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion12
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301101109MIMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Medical Center Current Accepting new patients
Munson Medical Center Neurological Surgery CurrentSince Jun 1, 2020 Accepting new patients
Munson Medical Center CurrentSince Jun 1, 2020 Accepting new patients
Munson Medical Center Past Accepting new patients

Locations

2513 Momentum Pl
Chicago, IL 60689
Phone (231) 935-8031

1221 Sixth St
Ste 300
Traverse City, MI 49684
Phone (231) 392-0640

1221 Sixth St
Traverse City, MI 49684
Phone (231) 392-0640

1400 Medical Campus Dr
Traverse City, MI 49684
Phone (231) 935-8000

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

Interoperability endpoints

  • Direct secure messaging: grajah@direct.mhc.net
  • Direct secure messaging: gary.rajah@gts.eclinicaldirectplus.com

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1457616849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 SIXTH ST STE 300",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842360",
            "telephone_number": "231-392-0640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST",
            "address_2": "6E DRH",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-4523"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1221 Sixth St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842360",
            "country_code": "US",
            "telephone_number": "231-392-0640",
            "fax_number": "231-392-0643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAJAH",
        "first_name": "GARY",
        "middle_name": "BENJAMIN",
        "name_suffix": "II",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-11",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MI",
            "license": "4301101109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Gary.rajah@gts.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "1221 Sixth St Ste 300",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496842360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.