MSU HEALTH CARE INC. (NPI# 1275165052) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275165052 |
| Entity Type | Organization |
| Organization Name | MSU HEALTH CARE INC. |
| Practice Address |
804 Service Rd Ste D100 East Lansing MI 48824-7015 |
| Mailing Address |
804 Service Rd Ste A109b East Lansing MI 48824-7015 |
| Practice Telephone | 5173535053 |
| Practice Fax Number | 5174324394 |
| Mailing Telephone | 5173535053 |
| Mailing Fax Number | 5174324394 |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2020-08-04 |
| Authorized Official Name | LISA M RUCKER (ENROLLMENT & PATIENT ACCTS MANAGER) |
| Authorized Official Telephone | 5173558462 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
Allopathic & Osteopathic Physicians | ||
| N | 2085B0100X |
Radiology Specialization: Body Imaging |
Allopathic & Osteopathic Physicians | ||
| N | 2085D0003X |
Radiology Specialization: Diagnostic Neuroimaging |
Allopathic & Osteopathic Physicians | ||
| N | 2085N0700X |
Radiology Specialization: Neuroradiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085N0904X |
Radiology Specialization: Nuclear Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085P0229X |
Radiology Specialization: Pediatric Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
Allopathic & Osteopathic Physicians | ||
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4660 S Hagadorn Rd Ste 410, East Lansing, MI 488236819 | 5173535053 | 5178846236 |
| 4660 S Hagadorn Rd Ste 600, East Lansing, MI 488235383 | 5173534920 | 5178840000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467083485 | Msu Health Care Inc. | Pharmacy | 4660 S Hagadorn Rd Ste 100, East Lansing, MI 48823-5353 | 2020-01-29 |
| 1740802958 | Msu Health Care Inc. | Pediatrics | 1200 E Michigan Ave Ste 145, Lansing, MI 48912-1897 | 2020-05-11 |
| 1760014633 | Msu Health Care Inc. | Internal Medicine | 401 W Greenlawn Ave, Lansing, MI 48910-2819 | 2020-02-10 |
| 1689206419 | Msu Health Care Inc. | Physical Therapy Assistant | 4660 S Hagadorn Rd Ste 400, East Lansing, MI 48823-5353 | 2020-02-10 |
| 1518599356 | Msu Health Care Inc. | Nurse Practitioner | 4660 S Hagadorn Rd Ste 420, East Lansing, MI 48823-5353 | 2020-02-10 |
| 1912539743 | Msu Health Care Inc. | Allergy & Immunology | 1200 E Michigan Ave Ste 145, Lansing, MI 48912-1897 | 2020-02-10 |
| 1396377115 | Msu Health Care Inc. | Medical Genetics | 4660 S Hagadorn Rd Ste 405, East Lansing, MI 48823-6819 | 2020-02-10 |
| 1396377131 | Msu Health Care Inc. | Orthopaedic Surgery | 4660 S Hagadorn Rd Ste 420, East Lansing, MI 48823-5353 | 2020-02-10 |
| 1053943928 | Msu Health Care Inc. | Psychiatry & Neurology | 804 Service Rd Ste A217, East Lansing, MI 48824-7015 | 2020-02-10 |
| 1356973119 | Msu Health Care Inc. | Orthopaedic Surgery | 4660 S Hagadorn Rd Ste 500, East Lansing, MI 48823-6804 | 2020-02-10 |
| Street Address |
804 SERVICE RD STE D100 |
| City | EAST LANSING |
| State | MI |
| Zip Code | 48824-7015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932286945 | Ryan Stephen Fajardo | Radiology | 804 Service Rd Ste D100, East Lansing, MI 48824-7015 | 2006-11-01 |
| 1083821300 | David Polinger-hyman | Radiology | 804 Service Rd Ste D100, East Lansing, MI 48824-7015 | 2007-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528680303 | Emilia Elizabeth Mattioli | Psychiatry & Neurology | 965 Fee Road Room A223, East Lansing, MI 48824 | 2020-05-14 |
| 1447871983 | James O'brien | Psychiatry & Neurology | Msu Psychiatry Residency Program, 965 Fee Road, Room A233, East Lansing, MI 48824 | 2020-05-06 |
| 1750916979 | Mulin Xiong | Student in an Organized Health Care Education/Training Program | 965 Wilson Road Suite A110, East Fee Hall, East Lansing, MI 48824 | 2020-03-09 |
| 1821659301 | Tovah Apolonia Aho | Psychiatry & Neurology | Michigan State University Psychiatric Residency, 965 Fee Road, Room A233, East Lansing, MI 48824 | 2019-06-25 |
| 1912564881 | Asmara Theresa Hoo | Psychiatry & Neurology | 965 Fee Road, Room A233, East Lansing, MI 48824 | 2019-05-24 |
| 1790276822 | Traverse Health Clinic and Coalition | Clinic/Center | East Fee Hall 965 Fee Road, Room A222, East Lansing, MI 48824 | 2018-05-24 |
| 1922598515 | Jubin Joseph Cheruvelil | Specialist/Technologist, Other | 446 W. Circle Dr. Room 249 Annex, Justin S. Morrill Hall of Agriculture, East Lansing, MI 48824 | 2018-05-18 |
| 1073003257 | Dawn Arvye Contreras | Health Educator | 446 West Circle Dr., Justin S. Morrill Hall of Agriculture, Room 166, East Lansing, MI 48824 | 2018-05-14 |
| 1710406046 | Kimberly Ann Breukink | Social Worker | 463 East Circle Drive, Michigan State University, Counseling and Psychiatric Services, East Lansing, MI 48824 | 2017-09-19 |
| 1043766314 | Ahmed Jouan | Psychiatry & Neurology | 804 Service Rd A217, East Lansing, MI 48824 | 2016-08-28 |
| Find all providers in zip 48824 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134483985 | Robert Jarrett Steffy | Radiology | 846 Service Rd, East Lansing, MI 48824-7017 | 2012-06-26 |
| 1386809036 | Charles Tribue Hounshell | Radiology | 4660 S Hagadorn Rd Ste 410, East Lansing, MI 48823-6819 | 2008-07-22 |
| 1053587535 | Thomas Loi | Radiology | 138 Service Rd Ste A204, East Lansing, MI 48824-1376 | 2008-05-05 |
| 1902007644 | Daniel Glen Vickers | Radiology | 138 Service Rd Ste D100, East Lansing, MI 48824-1313 | 2007-05-30 |
| 1417162819 | Andrew Guglielmi | Radiology | D100 Clinical Ctr, East Lansing, MI 48824-1313 | 2007-05-11 |
| 1932286945 | Ryan Stephen Fajardo | Radiology | 804 Service Rd Ste D100, East Lansing, MI 48824-7015 | 2006-11-01 |
| 1437246071 | Edward James Potchen | Radiology | 184 Radiology Building, East Lansing, MI 48824 | 2006-10-06 |
| 1679526867 | Bing Tai | Radiology | 627 Whitehills Dr, East Lansing, MI 48823-2731 | 2006-05-18 |
| 1275945768 | Julia Hobson | Radiology | 4660 S Hagadorn Rd Ste 410, East Lansing, MI 48823-6819 | 2014-06-02 |
| 1285074914 | Ezemonye O Madu | Radiology | 4660 S Hagadorn Rd Ste 600, East Lansing, MI 48823-5383 | 2013-06-26 |
| Find all providers in EAST LANSING | ||||
| City | EAST LANSING |
| Zip Code | 48824 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.