Individual provider Active NPI

Raymond Charles Edison, M.D.

  • Internal Medicine Physician
  • Southfield, MI
National Provider Identifier
1679782346
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301037643 Issued in MI
Practice address
25865 W 12 Mile Rd
Ste 101
Southfield, MI 48034-1817
Phone
(248) 557-3777
Fax
(248) 557-2666
NPI assigned
May 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Internal Medicine) Physician 207RA0401X 4301037643 MI
Internal Medicine Physician 207R00000X 4301037643 MI Primary

Addresses

Primary practice location

25865 W 12 Mile Rd
Ste 101
Southfield, MI 48034-1817

Mailing address

25865 W 12 Mile Rd Ste 101
Southfield, MI 48034-1817
Phone (248) 557-3777

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
I20090512000513 MI Practitioner - Internal MedicinePractitioner - Addiction Medicine 6901955426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Addiction Medicine
Education
Wayne State University School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metropolitan Rehabilitation Clinics, Inc.Group PAC ID 8022039742, 2 clinicians

Practice addresses (Care Compare)

20820 Greenfield Rd
Suite 100
Oak Park, MI 48237-3051
Phone (248) 967-4310

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Rehabilitation Clinics, Inc. CurrentSince Jan 23, 2017 Accepting new patients

Locations

21700 Greenfield Rd
Ste 130
Oak Park, MI 48237
Phone (248) 967-4310

20820 Greenfield Rd
Ste 100
Oak Park, MI 48237
Phone (248) 967-4301

Organizations & group practices 1

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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1679782346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25865 W 12 MILE RD STE 101",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341817",
            "telephone_number": "248-557-3777",
            "fax_number": "248-557-2666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25865 W 12 MILE RD",
            "address_2": "STE 101",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341817",
            "telephone_number": "248-557-3777",
            "fax_number": "248-557-2666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDISON",
        "first_name": "RAYMOND",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "MI",
            "license": "4301037643",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301037643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.