Individual provider Active NPI

Anmar Razak, M.D.

  • Vascular Neurology Physician
  • East Lansing, MI
National Provider Identifier
1154545853
Registry record updated Mar 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Neurology PhysicianTaxonomy code 2084V0102X
License
4301087375 Issued in MI
Practice address
804 Service Rd Room A217
East Lansing, MI 48824-7040
Phone
(517) 353-8122
Fax
(517) 432-3713
NPI assigned
Apr 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 4301087375 MI
Vascular Neurology Physician 2084V0102X 4301087375 MI Primary

Addresses

Primary practice location

804 Service Rd Room A217
East Lansing, MI 48824-7040

Mailing address

804 Service Rd
A201
East Lansing, MI 48824-7015
Phone (517) 884-2976

Other practice location 1

601 John St Ste M-124
Kalamazoo, MI 49007-5377
Phone (269) 341-7500

Other identifiers 1

IdentifierTypeStateIssuer
1154545853MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct Bronson Healthcare Group

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
I20110930000536 MI Practitioner - Neurology 8628240363 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edward W Sparrow Hospital AssociationGroup PAC ID 6709799166, 698 clinicians
Bronson Methodist HospitalGroup PAC ID 0244148633, 721 clinicians
Msu Health Care Inc.Group PAC ID 8628404936, 201 clinicians

Practice addresses (Care Compare)

1215 E Michigan Ave
Lansing, MI 48912-1811

601 John St
Suite 124
Kalamazoo, MI 49007-5377
Phone (269) 341-7500

804 Service Rd
East Lansing, MI 48824-7015
Phone (517) 353-8122

Hospital & facility affiliations

  • Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230
  • McLaren Greater Lansing Hospital, Lansing, MI, CCN 230167
  • Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017
  • University of Michigan Health - Sparrow Eaton Hospital, Charlotte, MI, CCN 231327

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301087375MIMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Msu Health Care Inc. CurrentSince Jul 1, 2020 Accepting new patients
Msu Health Care Inc CurrentSince Jul 1, 2020 Accepting new patients
Bronson Methodist Hospital Neurology CurrentSince Mar 1, 2017 Accepting new patients
Edward W Sparrow Hospital Association CurrentSince Jul 1, 2013 Accepting new patients
Edward W. Sparrow Hospital Association Neurology CurrentSince Jul 1, 2013 Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients
Capital Area Pathologists, PC Current Accepting new patients
Michigan State University Current Accepting new patients
Michigan State University Neurology CurrentSince Sep 1, 2011 Accepting new patients
Edward W Sparrow Hospital Association Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

4650 S Hagadorn Rd
Ste 100
East Lansing, MI 48823
Phone (517) 353-4830

804 Service Rd
Rm A217
East Lansing, MI 48824
Phone (517) 353-8122

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

804 Service Rd
Ste A217
East Lansing, MI 48824
Phone (517) 353-8122

804 Service Rd
#A109F
East Lansing, MI 48824
Phone (517) 884-2976

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

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

401 W Greenlawn Ave
Lansing, MI 48910
Phone (517) 334-2286

Interoperability endpoints

  • Direct secure messaging: direct@direct.bronsonhg.org
  • Direct secure messaging: anmar.razak.1@25394.direct.athenahealth.com

Organizations & group practices 11

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 7

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1154545853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD",
            "address_2": "A201",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "517-884-2976",
            "fax_number": "517-432-3928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD ROOM A217",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247040",
            "telephone_number": "517-353-8122",
            "fax_number": "517-432-3713"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 John St Ste M-124",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490075377",
            "country_code": "US",
            "telephone_number": "269-341-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAZAK",
        "first_name": "ANMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "4301087375",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "MI",
            "license": "4301087375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154545853",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "affiliationName": "Bronson Healthcare Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

Verify at the official NPI Registry.