Individual provider Active NPI

Jacob Joseph Rowan, D.O.

  • Physical Medicine & Rehabilitation Physician
  • East Lansing, MI
National Provider Identifier
1063517340
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
5101014827 Issued in MI
Practice address
4660 S Hagadorn Rd Ste 500
East Lansing, MI 48823-6804
Phone
(517) 432-6144
Fax
(517) 432-6150
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 5101014827 MI
Physical Medicine & Rehabilitation Physician 208100000X 5101014827 MI Primary

Addresses

Primary practice location

4660 S Hagadorn Rd Ste 500
East Lansing, MI 48823-6804

Mailing address

804 Service Rd Ste A109B
East Lansing, MI 48824-7015
Phone (517) 432-6144

Other identifiers 2

IdentifierTypeStateIssuer
4624101MedicaidMI
1922043389MedicaidMI

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
I20040824001098 MI Practitioner - Osteopathic Manipulative MedicinePractitioner - Physical Medicine and Rehabilitation 7618941733 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative MedicineAlso: Physical Medicine and Rehabilitation
Education
Michigan State University College of Osteopathic Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Msu Health Care Inc.Group PAC ID 8628404936, 201 clinicians

Practice addresses (Care Compare)

4660 S Hagadorn Rd
Suite 500
East Lansing, MI 48823-6804
Phone (517) 432-6144

Hospital & facility affiliations

  • McLaren Greater Lansing Hospital, Lansing, MI, CCN 230167

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101014827MIMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Msu Health Care Inc CurrentSince Jul 1, 2020 Accepting new patients
Michigan State University CurrentSince Jul 1, 2004 Accepting new patients
Msu Health Care Inc. CurrentSince Jul 1, 2020 Accepting new patients
Michigan State University Current Accepting new patients
Michigan State University CurrentSince Jul 1, 2004 Accepting new patients
Vpa PC Past Accepting new patients
Vpa PC Past Accepting new patients

Locations

804 Service Rd
Ste A109B
East Lansing, MI 48824
Phone (517) 884-2976

4660 S Hagadorn Rd
Ste 500
East Lansing, MI 48823
Phone (517) 432-6144

4660 S Hagadorn Rd
Ste 420
East Lansing, MI 48823
Phone (517) 884-6100

1600 W Grand River Ave
Ste 2
Okemos, MI 48864
Phone (517) 349-6560

Interoperability endpoints

  • Direct secure messaging: jacob.rowan.1@25394.direct.athenahealth.com

Organizations & group practices 7

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1063517340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD STE A109B",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "517-432-6144",
            "fax_number": "517-432-6150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 S HAGADORN RD STE 500",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488236804",
            "telephone_number": "517-432-6144",
            "fax_number": "517-432-6150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROWAN",
        "first_name": "JACOB",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "MI",
            "license": "5101014827",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "5101014827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4624101",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922043389",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

Verify at the official NPI Registry.