GENESIS SURGERY CENTER (NPI# 1578530630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578530630 |
| Entity Type | Organization |
| Organization Name | GENESIS SURGERY CENTER |
| Practice Address |
3400 E Jolly Rd Lansing MI 48910-8542 |
| Practice Telephone | 5172721063 |
| Practice Fax Number | 5172721685 |
| Mailing Telephone | 5172721063 |
| Mailing Fax Number | 5172721685 |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2008-03-13 |
| Authorized Official Name | DR. DAVID DESTRISAC (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 5172721063 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
336817 | MI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBS-2ND | 0C37001 | 01 |
| MI | BLUE CROSS BLUE SHIELD | 40369 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629597216 | Genesis Surgery Center | Clinic/Center | 8950 W Emerald St Ste 164, Boise, ID 83704-8296 | 2017-09-14 |
| Street Address |
3400 E JOLLY RD |
| City | LANSING |
| State | MI |
| Zip Code | 48910-8542 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942397344 | Genesis Asc Partners LLC | Clinic/Center | 3400 E Jolly Rd, Lansing, MI 48910-8542 | 2006-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821604562 | Wendy Lynne Hughes | Licensed Practical Nurse | 2025 S Washington Ave Suite 210 Lansing, Mi 48910, Lansing, MI 48910 | 2020-09-18 |
| 1073146908 | James Laroach | Peer Specialist | 913 W. Homes Suite 200, Lansing, MI 48910 | 2020-02-19 |
| 1487284279 | Kourtia Nicole Munson | Counselor | 2025 S Washighton Ave, Suite 210, Lansing, MI 48910 | 2020-01-21 |
| 1699248112 | Cedar Pharmacy LLC | Pharmacy | 2513 S Cedar St., Lansing, MI 48910 | 2019-01-08 |
| 1134604390 | Kazuho Kondo | Student in an Organized Health Care Education/Training Program | 3338 Beau Jardin Dr., 0812, Lansing, MI 48910 | 2018-10-03 |
| 1477036655 | Dalia Elgohary | Pharmacist | 5016 S Martin Luther King, Lansing, MI 48910 | 2018-09-13 |
| 1457856940 | Derrick Lynn Byrd | Social Worker | 4305 S. Cedar St., Lansing, MI 48910 | 2018-03-27 |
| 1326564964 | Lansing Health Supplies | Durable Medical Equipment & Medical Supplies | 3105 S Martin Luther King Blvd #320, Lansing, MI 48910 | 2017-08-15 |
| 1265957203 | Heather E Dover | Dietitian, Registered | 2510 Solomon Dr, Lansing, MI 48910 | 2017-08-10 |
| 1407307705 | Elise Evans | Occupational Therapist | 2331 East Jolly Rd, Suite B, Lansing, MI 48910 | 2016-10-21 |
| Find all providers in zip 48910 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962479014 | Lansing Surgery Center | Clinic/Center | 1707 Lake Lansing Rd, Lansing, MI 48912-3742 | 2006-03-07 |
| 1942397344 | Genesis Asc Partners LLC | Clinic/Center | 3400 E Jolly Rd, Lansing, MI 48910-8542 | 2006-10-06 |
| 1790886372 | Lake Lansing Asc Partners LLC | Clinic/Center | 1707 Lake Lansing Rd, Lansing, MI 48912-3742 | 2006-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891306114 | Spine and Joint Surgical Institute of Michigan, LLC | Clinic/Center | 5140 Coolidge Hwy, Ste 200, Royal Oak, MI 48073 | 2020-08-11 |
| 1588285050 | Hall Road Asc LLC | Clinic/Center | 11051 Hall Rd Ste 100, Utica, MI 48317-5737 | 2020-05-06 |
| 1235750431 | Precision Surgery Center LLC | Clinic/Center | 22701 Hall Road, Macomb, MI 48042 | 2020-04-29 |
| 1790306991 | Grass Lake Surgery Center LLC | Clinic/Center | 3800 Centennial Blvd, Grass Lake, MI 49240 | 2020-04-29 |
| 1992339147 | Movi Asc Management LLC | Clinic/Center | 5250 Auto Club Drive, Suite 170, Dearborn, MI 48126-2619 | 2020-02-26 |
| 1609409929 | Firestone Procedure Center LLC | Clinic/Center | 4520 Firestone St Ste C, Dearborn, MI 48126-4602 | 2020-02-14 |
| 1255972113 | Center Health Surgery Center LLC | Clinic/Center | 30671 Stephenson Hwy Ste F, Madison Heights, MI 48071-1635 | 2019-10-02 |
| 1942851639 | Northern Michigan Surgical Suites, LLC | Clinic/Center | 825 Moll Dr, Boyne City, MI 49712-9182 | 2019-09-24 |
| 1699328146 | Alliance Surgery Center, LLC | Clinic/Center | 3663 North Country Drive, Traverse City, MI 49684-4587 | 2019-07-23 |
| 1407313802 | Spectrum Health Hospitals | Clinic/Center | 4069 Lake Dr Se Ste 210, Grand Rapids, MI 49546-8816 | 2019-02-22 |
| Find all providers with the same taxonomy | ||||
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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.