NPIMap

Individual provider Active NPI

Racha W Boulos, MD

  • Anesthesiology Physician
  • Midland, MI
National Provider Identifier
1689135196
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4301512283 Issued in MI
Practice address
4000 Wellness Dr
Midland, MI 48670-1000
Phone
(989) 839-3000
Fax
(989) 839-3168
NPI assigned
Mar 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 4301512283 MI Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

4000 Wellness Dr
Midland, MI 48670-1000

Mailing address

4000 Wellness Dr
Midland, MI 48670-1000
Phone (844) 832-1956

Other names 1

  • Racha W Tadros Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240916000896 MI Practitioner - Anesthesiology 1355889742 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians
Mymichigan Medical Center MidlandGroup PAC ID 2264323633, 507 clinicians

Practice addresses (Care Compare)

2799 W Grand Boulevard
Detroit, MI 48202-2608
Phone (313) 916-2000

4000 Wellness Dr
Midland, MI 48670-2000
Phone (989) 839-3000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Anesthesiology CurrentSince Aug 7, 2024 Accepting new patients
Henry Ford Pathology Current Accepting new patients
Henry Ford Health System CurrentSince Aug 7, 2024 Accepting new patients
Henry Ford Health System Current Accepting new patients

Locations

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

Interoperability endpoints

  • Direct secure messaging: rtadros543237@direct.hfhs.org
  • FHIR API: https://fhir.hfhs.org/FHIRProxy/api/FHIR/R4/

Organizations & group practices 5

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 7

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": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1689135196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486701000",
            "telephone_number": "844-832-1956",
            "fax_number": "989-633-5241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486701000",
            "telephone_number": "989-839-3000",
            "fax_number": "989-839-3168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULOS",
        "first_name": "RACHA",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-27",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301512283",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHA",
            "last_name": "TADROS",
            "middle_name": "W",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.