Individual provider Active NPI

Victor A Elgabalawi

  • Hospitalist Physician
  • Lansing, MI
National Provider Identifier
1104143296
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
4301097353 Issued in MI
Practice address
1215 E Michigan Ave
Lansing, MI 48912-1811
Phone
(517) 364-3380
Fax
(517) 364-3399
NPI assigned
Apr 28, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301097353 MI
Hospitalist Physician 208M00000X 4301097353 MI Primary

Addresses

Primary practice location

1215 E Michigan Ave
Lansing, MI 48912-1811

Mailing address

PO Box 13008
Lansing, MI 48901-3008
Phone (517) 364-6253

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
I20160721000265 MI Practitioner - HospitalistPractitioner - Internal Medicine 8022301530 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Michigan State University College of Human Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vituity - Michigan Hospitalists PCGroup PAC ID 2365860996, 76 clinicians

Practice addresses (Care Compare)

1215 E Michigan Ave
Lansing, MI 48912-1811
Phone (517) 364-1000

Hospital & facility affiliations

  • Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sparrow Ionia Hospital Current Accepting new patients
Sparrow Clinton Hospital CurrentSince Jul 18, 2016 Accepting new patients
Vituity - Michigan Hospitalists PC Internal Medicine CurrentSince Sep 1, 2020 Accepting new patients
Sparrow Ionia Hospital Internal Medicine CurrentSince Jul 10, 2016 Accepting new patients
Sparrow Ionia Hospital CurrentSince Jul 10, 2016 Accepting new patients
Sparrow Clinton Hospital CurrentSince Jul 18, 2016 Accepting new patients
Edward W Sparrow Hospital Association Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

8175 Reliable Pkwy
Chicago, IL 60686

406 E Elm St
Carson City, MI 48811
Phone (517) 584-3131

3565 S State Rd
Ionia, MI 48846
Phone (616) 523-1355

550 E Washington St
Ionia, MI 48846
Phone (616) 523-1600

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

1215 E Michigan Ave
#8W
Lansing, MI 48912
Phone (517) 364-2614

805 S Oakland St
Saint Johns, MI 48879
Phone (989) 224-6881

Organizations & group practices 8

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 2

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": "1272412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1104143296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13008",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489013008",
            "telephone_number": "517-364-6253",
            "fax_number": "517-364-6204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 E MICHIGAN AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121811",
            "telephone_number": "517-364-3380",
            "fax_number": "517-364-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELGABALAWI",
        "first_name": "VICTOR",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-28",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301097353",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MI",
            "license": "4301097353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.