Individual provider Active NPI

Leila Ghasemi

  • Nurse Practitioner
  • East Lansing, MI
National Provider Identifier
1174018394
Registry record updated Jun 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704284961 Issued in MI
Practice address
221 W Lake Lansing Rd Ste 300
East Lansing, MI 48823-8661
Phone
(517) 515-1572
NPI assigned
Jun 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704284961 MI Primary

Addresses

Primary practice location

221 W Lake Lansing Rd Ste 300
East Lansing, MI 48823-8661

Mailing address

1724 Melrose Ave
East Lansing, MI 48823-3728
Phone (517) 515-1572

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260611002665 MI Practitioner - Nurse Practitioner 5092287912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4055 Valley View LN
Suite 700
Dallas, TX 75244-4910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704284961MIMDNurse Practitioner

Interoperability endpoints

  • Direct secure messaging: lghasemi620024@direct.hfhs.org

Organizations & group practices 1

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": "1530230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1174018394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1724 MELROSE AVE",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488233728",
            "telephone_number": "517-515-1572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W LAKE LANSING RD STE 300",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488238661",
            "telephone_number": "517-515-1572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHASEMI",
        "first_name": "LEILA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-29",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704284961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

Verify at the official NPI Registry.