Individual provider Active NPI

Brett Eric Etchebarne, M.D., PH.D.

  • Emergency Medicine Physician
  • Lansing, MI
National Provider Identifier
1164719134
Registry record updated Jul 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4301099282 Issued in MI
Practice address
1215 E Michigan Ave
Sparrow Hospital
Lansing, MI 48912
Phone
(517) 364-1000
NPI assigned
Jun 29, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301099282 MI Primary

Addresses

Primary practice location

1215 E Michigan Ave
Sparrow Hospital
Lansing, MI 48912

Mailing address

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

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
I20140604000464 MI Practitioner - Emergency Medicine 0648493023 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Michigan State University College of Human Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vituity - Michigan Em PCGroup PAC ID 8022414010, 51 clinicians
McLaren Hospital GroupGroup PAC ID 2365968351, 366 clinicians

Practice addresses (Care Compare)

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

2900 Collins Rd
Lansing, MI 48910-8394
Phone (517) 975-7500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301099282MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vituity - Michigan Em PC Emergency Medicine CurrentSince Nov 1, 2021 Accepting new patients
McLaren Hospital Group Emergency Medicine CurrentSince Aug 1, 2025 Accepting new patients
Degara App, PLLC Emergency Medicine CurrentSince Mar 26, 2017 Accepting new patients

Locations

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

321 E Harris St
Charlotte, MI 48813
Phone (517) 541-5840

5701 Bow Pointe Dr
Ste 120
Clarkston, MI 48346
Phone (248) 625-2273

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

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

2900 Collins Rd
Lansing, MI 48910
Phone (517) 975-7500

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

385 N Lapeer Rd
Oxford, MI 48371
Phone (248) 628-2597

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

Organizations & group practices 3

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 3

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": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1164719134",
    "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": "1215 E MICHIGAN AVE",
            "address_2": "SPARROW HOSPITAL",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "48912",
            "telephone_number": "517-364-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETCHEBARNE",
        "first_name": "BRETT",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-29",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301099282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.