Individual provider Active NPI

Elizabeth Kozlowski, DO

  • Family Medicine Physician
  • East Lansing, MI
National Provider Identifier
1104804285
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101014400 Issued in MI
Practice address
921 Abbot Rd Ste South
East Lansing, MI 48823-3170
Phone
(517) 299-0663
Fax
(517) 299-0669
NPI assigned
Jan 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101014400 MI Primary

Addresses

Primary practice location

921 Abbot Rd Ste South
East Lansing, MI 48823-3170

Mailing address

921 Abbot Rd Ste South
East Lansing, MI 48823-3170
Phone (517) 299-0663

Other identifiers 3

IdentifierTypeStateIssuer
1104804285MedicaidMI
853303415OtherMIBCBS PIN
200000014548OtherMIPHP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Feb 4, 2025 through Feb 4, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101014400MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kozmic Counseling CurrentSince Aug 25, 2025 Accepting new patients
Healthtexas Provider Network Family Medicine PastSince Dec 15, 2007 Accepting new patients

Locations

921 Abbott Rd
Ste S
East Lansing, MI 48823
Phone (517) 299-0663

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1104804285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 ABBOT RD STE SOUTH",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488233170",
            "telephone_number": "517-299-0663",
            "fax_number": "517-299-0669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 ABBOT RD STE SOUTH",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488233170",
            "telephone_number": "517-299-0663",
            "fax_number": "517-299-0669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZLOWSKI",
        "first_name": "ELIZABETH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-09",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101014400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104804285",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "853303415",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "200000014548",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

Verify at the official NPI Registry.