Individual provider Active NPI

Alonso Collar, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Lansing, MI
National Provider Identifier
1174521025
Registry record updated Jul 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
4301043194 Issued in MI
Practice address
405 W Greenlawn Ave
Ste 305
Lansing, MI 48910-2898
Phone
(517) 483-7544
Fax
(517) 483-4862
NPI assigned
Jul 13, 2005
Last updated
Jul 1, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 4301043194 MI Primary

Addresses

Primary practice location

405 W Greenlawn Ave
Ste 305
Lansing, MI 48910-2898

Mailing address

405 W Greenlawn Ave
Suite 305
Lansing, MI 48910-2898
Phone (517) 483-7544

Other identifiers 1

IdentifierTypeStateIssuer
1174521025MedicaidMI

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
I20060131000181 MI Practitioner - Thoracic Surgery 5991617615 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Edward W. Sparrow Hospital Association Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Jul 1, 2011 Accepting new patients
Edward W Sparrow Hospital Association CurrentSince Jul 1, 2011 Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

1200 E Michigan Ave
Ste 775
Lansing, MI 48912
Phone (517) 364-5160

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

3500 S Cedar St
Ste 116
Lansing, MI 48910

405 W Greenlawn Ave
Ste 305
Lansing, MI 48910
Phone (517) 483-4780

405 W Greenlawn Ave
Ste 400
Lansing, MI 48910
Phone (517) 483-7541

Interoperability endpoints

  • Direct secure messaging: acollar84949@mymichiganhealth.midirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277942400000",
    "number": "1174521025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 W GREENLAWN AVE",
            "address_2": "SUITE 305",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489102898",
            "telephone_number": "517-483-7544",
            "fax_number": "517-483-4862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W GREENLAWN AVE",
            "address_2": "STE 305",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489102898",
            "telephone_number": "517-483-7544",
            "fax_number": "517-483-4862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLAR",
        "first_name": "ALONSO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2010-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MI",
            "license": "4301043194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174521025",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.