Derissa Raynold, MD
NPI 1083351506 · Student in an Organized Health Care Education/Training Program · Kalamazoo, MI
Enrolled with Medicare as Order and Referring Only - Family Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Derissa Raynold, MD is a Student in an Organized Health Care Education/Training Program provider in Kalamazoo, MI (NPI 1083351506).
Provider details
- NPI number
- 1083351506
- Entity type
- Individual
- Primary specialty
- Student in an Organized Health Care Education/Training ProgramStudent, Health Care
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- License
- 4351049698 (MI)
Specialties & taxonomies
- Student in an Organized Health Care Education/Training ProgramPrimary390200000XLicense 4351049698 (MI)
Student, Health Care
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2022-05-16
- Last updated
- 2022-05-27
- Certified
- 2022-05-27
Frequently asked questions
- What is Derissa Raynold's NPI number?
- Derissa Raynold's National Provider Identifier (NPI) is 1083351506, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Derissa Raynold's specialty?
- Derissa Raynold is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program (Student, Health Care).
- Where is Derissa Raynold located?
- Derissa Raynold's practice location on file with NPPES is 1000 Oakland Dr, Kalamazoo, MI 49008-1282.
- What is Derissa Raynold's phone number?
- The practice phone number listed in the NPPES registry for Derissa Raynold is (269) 337-4600.
- Does Derissa Raynold accept Medicare?
- Derissa Raynold is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Derissa Raynold's NPI active?
- Yes — Derissa Raynold's NPI (1083351506) is active in the NPPES registry as of the last update on 2022-05-27.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.