Active NPI
St Joseph Mercy Hospital
- Clinical Pathology/Laboratory Medicine Physician
- Ypsilanti, MI
National Provider Identifier
1609995125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Pathology/Laboratory Medicine Physician
- Legal business name
- ST JOSEPH MERCY HOSPITAL
- Practice address
- 5301 E Huron River Dr
Pathology Department
Ypsilanti, MI 48197-1051 - Phone
- (734) 712-5989
- NPI assigned
- Mar 28, 2007
- Last updated
- May 5, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ariana Grace Raymond
- Title
- Manager Provider Enrollment
- Phone
- (734) 343-1466
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | NU | ||
| Molecular Genetic Pathology (Pathology) Physician | 207ZP0007X | NU | ||
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | NU | ||
| Clinical Pathology/Laboratory Medicine Physician | 207ZP0105X | NU | Primary |
Addresses
Primary practice location
5301 E Huron River Dr
Pathology Department
Ypsilanti, MI 48197-1051
Mailing address
34505 W 12 Mile Rd Ste 200
Farmington Hills, MI 48331-3286
Phone (734) 343-3922
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 220H161560 | Other | MI | BS BCN PATHOLOGY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Cobius Healthcare Solutions |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040226001002 | MI | Part B Supplier - Clinic/Group Practice | 3779489281 |
Receives reassigned benefits from 299 practitioners 12 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Ypsilanti, MI; Canton, MI; Saline, MI; Ann Arbor, MI |
Other NPIs on the same Medicare enrollment 12
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Trinity Health Ann Arbor Hospital
- Internal Medicine Physician
- Ypsilanti, MI
- NPI 1730207580
O20040226001002
-
- Geriatric Medicine (Internal Medicine) Physician
- Ypsilanti, MI
- NPI 1932228590
O20040226001002
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1777939200000",
"number": "1609995125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34505 W 12 MILE RD STE 200",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483313286",
"telephone_number": "734-343-3922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5301 E HURON RIVER DR",
"address_2": "PATHOLOGY DEPARTMENT",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481971051",
"telephone_number": "734-712-5989"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST JOSEPH MERCY HOSPITAL",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-28",
"last_updated": "2026-05-05",
"certification_date": "2026-05-05",
"status": "A",
"authorized_official_last_name": "RAYMOND",
"authorized_official_first_name": "ARIANA",
"authorized_official_middle_name": "GRACE",
"authorized_official_title_or_position": "MANAGER PROVIDER ENROLLMENT",
"authorized_official_telephone_number": "734-343-1466"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207ZP0007X",
"taxonomy_group": "",
"desc": "Pathology, Molecular Genetic Pathology",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207ZP0105X",
"taxonomy_group": "",
"desc": "Pathology, Clinical Pathology/Laboratory Medicine",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BS BCN PATHOLOGY",
"identifier": "220H161560",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.1068.1",
"affiliationName": "Cobius Healthcare Solutions",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD Emdr",
"address_1": "2720 Dundee Rd # 302",
"city": "Northbrook",
"state": "IL",
"country_code": "US",
"postal_code": "600622609",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Ypsilanti, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.