Individual provider Active NPI

Lydia Joy Rayes, D.O.

  • Family Medicine Physician
  • Roseville, MI
National Provider Identifier
1740625524
Registry record updated Sep 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101020473 Issued in MI
Practice address
18303 E 10 Mile Rd
Suite 500
Roseville, MI 48066-4988
Phone
(586) 498-5160
Fax
(586) 498-5199
NPI assigned
May 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101020473 MI Primary

Addresses

Primary practice location

18303 E 10 Mile Rd
Suite 500
Roseville, MI 48066-4988

Mailing address

18303 E 10 Mile Rd
Suite 500
Roseville, MI 48066-4988
Phone (586) 498-5160

Other identifiers 1

IdentifierTypeStateIssuer
5501705OtherMIBCBS INDIVIDUAL PIN

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
I20160425000926 MI Practitioner - Family Practice 5092011742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

18303 E 10 Mile Rd
500 St John Center for Wellness and Family Me
Roseville, MI 48066-4992
Phone (586) 498-5160

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101020473MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Cornerstone Medical Group Family Medicine Current Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Sep 1, 2016 Accepting new patients
Henry Ford Health St. John Hospital Current Accepting new patients
Henry Ford Health St. John Hospital Family Medicine CurrentSince Sep 1, 2016 Accepting new patients
St. John Hospital Past Accepting new patients

Locations

42645 Garfield Rd
Ste 103
Clinton Twp, MI 48038
Phone (586) 286-0050

46591 Romeo Plank Rd
Macomb, MI 48044
Phone (586) 226-6269

18303 E 10 Mile Rd
Ste 500
Roseville, MI 48066
Phone (586) 498-5160

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/mQjCqHb5rkr1u1foU4dqhQPBpi7Qk9R4/
  • Direct secure messaging: lrayes1148683@direct.hfhs.org

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 2

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": "1367884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1740625524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18303 E 10 MILE RD",
            "address_2": "SUITE 500",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664988",
            "telephone_number": "586-498-5160",
            "fax_number": "586-498-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18303 E 10 MILE RD",
            "address_2": "SUITE 500",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664988",
            "telephone_number": "586-498-5160",
            "fax_number": "586-498-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYES",
        "first_name": "LYDIA",
        "middle_name": "JOY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-07",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101020473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL PIN",
            "identifier": "5501705",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MI

Sources for this page

Verify at the official NPI Registry.