Individual provider Active NPI

Rajan Ravikumar, M.D.

  • Allergy & Immunology Physician
  • Brighton, MI
National Provider Identifier
1790734564
Registry record updated Feb 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
4301076537 Issued in MI
Practice address
7500 Challis Rd
2ND Floor
Brighton, MI 48116-9416
Phone
(734) 647-5940
NPI assigned
May 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X MD428811 PA
Internal Medicine Physician 207R00000X 4301076537 MI
Allergy & Immunology Physician 207K00000X 4301076537 MI Primary

Addresses

Primary practice location

7500 Challis Rd
2ND Floor
Brighton, MI 48116-9416

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

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
I20150803002532 MI Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 1254337231 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Internal Medicine
Education
Rutgers New Jersey Medical School, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the University of MichiganGroup PAC ID 3779496856, shared by 45 NPIs, 3,344 clinicians

Practice addresses (Care Compare)

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105-9484

7500 Challis Rd
Brighton, MI 48116-9416
Phone (810) 263-4000

8001 Challis Rd
Brighton, MI 48116-7446
Phone (810) 227-9510

Hospital & facility affiliations

  • University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301076537MIMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan CurrentSince Jun 29, 2015 Accepting new patients
Regents of the University of Michigan Allergy & Immunology CurrentSince Jun 29, 2015 Accepting new patients
Regents of the University of Michigan Internal Medicine Current Accepting new patients
Regents of the University of Michigan Allergy & Immunology Past Accepting new patients

Locations

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

8001 Challis Rd
Brighton, MI 48116
Phone (810) 227-9510

7500 Challis Rd
Brighton, MI 48116
Phone (734) 764-4190

7500 Challis Rd
Fl 2
Brighton, MI 48116
Phone (734) 647-5940

Interoperability endpoints

  • Direct secure messaging: rravikumar632174@direct.med.umich.edu
  • Direct secure messaging: rajan.ravikumar.1@4327.direct.athenahealth.com

Organizations & group practices 4

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 1

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549584000000",
    "number": "1790734564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 CHALLIS RD",
            "address_2": "2ND FLOOR",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481169416",
            "telephone_number": "734-647-5940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVIKUMAR",
        "first_name": "RAJAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2019-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "PA",
            "license": "MD428811",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301076537",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "MI",
            "license": "4301076537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MI

Sources for this page

Verify at the official NPI Registry.