Ivan Rakic

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

2085R0204X Issued in MI

Practice address

270 E Palmer St
Detroit, MI 48202-3824

Phone

(773) 307-0710

NPI assigned

Mar 26, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: irakic731515@memorialhermann.direct-ci.com

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

{
    "created_epoch": "1711411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1487404968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 E PALMER ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 E PALMER ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023824",
            "telephone_number": "773-307-0710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAKIC",
        "first_name": "IVAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-26",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MI",
            "license": "2085R0204X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawqi M. Raji, MA
• Madhvi Atul Rajpurkar, MD
• Salman Rajput, MD
• Heather Rajter, RN
• Nadimpalli V Raju, MD
• Maryanne Rakidzioski, M.O.T
• Ilya Rakitin, M.D.
• Neeraja Ramachandra, M.D.
• Sampath Ramachandran, M.D.
• Virginia Sue Ramachandran, AU.D.

• Vascular & Interventional Radiology Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Vascular & Interventional Radiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.