DR. RICHARD D KUSTASZ (NPI# 1720175466) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720175466 |
| Entity Type | Individual |
| Full Name | DR. RICHARD D KUSTASZ |
| Credential | D.O. |
| Practice Address |
463 East Circle Drive East Lansing MI 48824-1037 |
| Mailing Address |
804 Service Rd A201 East Lansing MI 48824-7015 |
| Practice Telephone | 5178846546 |
| Practice Fax Number | 5174329460 |
| Mailing Telephone | 5178842976 |
| Mailing Fax Number | 5174323928 |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2016-06-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 5101013047 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | PRIORITY HEALTH PAY TO # | 02017 | 01 |
| MI | TRICARE | 383218134 | 01 |
| MI | MOLINA | 4424862 | 01 |
| MI | BCBS GROUP NUMBER | 700C460070 | 01 |
| MI | 114424862 | 05 | |
| MI | 1720175466 | 05 | |
| MI | PHPMM | 200000002259 | 01 |
| MI | MCLAREN | 1015065 | 01 |
| Street Address |
463 EAST CIRCLE DRIVE |
| City | EAST LANSING |
| State | MI |
| Zip Code | 48824-1037 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942300660 | Lydia A Huber | Physician Assistant | 463 East Circle Drive, East Lansing, MI 48824-1037 | 2006-09-23 |
| 1821310921 | Cara Teresa Ludlow | Counselor | 463 East Circle Drive, Room 102, East Lansing, MI 48824-1037 | 2010-02-17 |
| 1780834069 | Michelle M Hafner | Physician Assistant | 463 East Circle Drive, East Lansing, MI 48824-1037 | 2008-09-24 |
| 1528227709 | Rebecca Marie Smith | Psychiatry & Neurology | 463 East Circle Drive, East Lansing, MI 48824-1037 | 2008-06-03 |
| 1609083732 | Swapna Hingwe | Psychiatry & Neurology | 463 East Circle Drive, Olin Health Center, East Lansing, MI 48824-1037 | 2007-05-17 |
| 1992884886 | Michigan State University | Clinic/Center | 463 East Circle Drive, Rm B35, East Lansing, MI 48824-1037 | 2006-11-03 |
| 1750462511 | Sara Lynn Kiefer | Nurse Practitioner | 463 East Circle Drive, East Lansing, MI 48824-1037 | 2006-10-18 |
| 1336229285 | James W Cowan | Physician Assistant | 463 East Circle Drive, East Lansing, MI 48824-1037 | 2006-10-16 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730740507 | Hannah Finnerty | Family Medicine | 2852 Eyde Pkwy Ste 175, East Lansing, MI 48823-5378 | 2019-06-24 |
| 1588158869 | Ralph A. Harvey Md, Pllc | Family Medicine | 1350 E Lake Lansing Rd Ste C, East Lansing, MI 48823-7413 | 2018-06-19 |
| 1972999365 | Jennifer Renee Mccaskill | Family Medicine | 2900 Hannah Blvd Ste 216, East Lansing, MI 48823 | 2015-04-13 |
| 1124111026 | Full Spectrum Family Medicine PC | Family Medicine | 2025 Abbot Rd, Suite 100, East Lansing, MI 48823-8573 | 2006-10-02 |
| 1972609683 | Mary Elizabeth Thorne | Family Medicine | 1280 Chartwell Carriage Way North, East Lansing, MI 48823-2404 | 2006-09-16 |
| 1477658565 | William Holding Page-echols | Family Medicine | 2025 Abbott Rd, Suite 100, East Lansing, MI 48823-8573 | 2006-09-13 |
| 1982706560 | Heidi J. Johnson | Family Medicine | 2035 Asher Ct, Suite 200, East Lansing, MI 48823-8480 | 2006-09-02 |
| 1396859013 | Carol Lynn Monson | Family Medicine | 804 Clinical Center, A235, East Lansing, MI 48824 | 2006-08-19 |
| 1689602971 | Michael J Chamot | Family Medicine | 107 Olin Health Center, East Circle Dr, East Lansing, MI 48824-1037 | 2006-06-28 |
| 1346276144 | David Todd Walsworth | Family Medicine | 804 Service Rd # A142, East Lansing, MI 48824-7015 | 2006-06-23 |
| 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.