Individual provider Active NPI

Joash Ajay Raj, MD

  • Pediatrics Physician
  • Hudsonville, MI
National Provider Identifier
1487642021
Registry record updated Feb 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301080648 Issued in MI
Practice address
3152 Port Sheldon St
Suite C
Hudsonville, MI 49426-9297
Phone
(616) 669-9238
NPI assigned
Oct 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301080648 MI Primary

Addresses

Primary practice location

3152 Port Sheldon St
Suite C
Hudsonville, MI 49426-9297

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560

Other names 1

  • Ajay Joash Raj Other name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address Joash.Raj@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/

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
I20050728000853 MI Practitioner - Pediatric Medicine 1951339290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3152 Port Sheldon St
Hudsonville, MI 49426-9297
Phone (616) 494-5830

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners Current Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Oct 1, 2012 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Oct 1, 2012 Accepting new patients

Locations

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

3152 Port Sheldon St
Ste C
Hudsonville, MI 49426
Phone (616) 669-9238

3152 Port Sheldon St
Hudsonville, MI 49426
Phone (616) 669-3558

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

Interoperability endpoints

  • Direct secure messaging: joash.raj@epic00.shdirect.org
  • Direct secure messaging: jraj4614@epic00.corewelldirect.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1487642021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3152 PORT SHELDON ST",
            "address_2": "SUITE C",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494269297",
            "telephone_number": "616-669-9238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJ",
        "first_name": "JOASH",
        "middle_name": "AJAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301080648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Joash.Raj@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "3152 Port Sheldon St",
            "address_2": "Suite C",
            "city": "Hudsonville",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494269297",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3152 Port Sheldon St",
            "address_2": "Suite C",
            "city": "Hudsonville",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494269297",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AJAY",
            "last_name": "RAJ",
            "middle_name": "JOASH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hudsonville, MI

Sources for this page

Verify at the official NPI Registry.