Individual provider Active NPI

Pavel Volkov, DO

  • Physical Medicine & Rehabilitation Physician
  • East Lansing, MI
National Provider Identifier
1205458452
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
5101027590 Issued in MI
Practice address
4660 S Hagadorn Rd Ste 500
East Lansing, MI 48823-6804
Phone
(517) 884-8701
Fax
(517) 884-8787
NPI assigned
May 11, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 5101027590 MI Primary

Addresses

Primary practice location

4660 S Hagadorn Rd Ste 500
East Lansing, MI 48823-6804

Mailing address

804 Service Rd Ste A202
East Lansing, MI 48824-7015
Phone (517) 884-8701

Other practice location 1

1200 E Michigan Ave Ste 520
Lansing, MI 48912-1899
Phone (517) 364-5260

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
I20240612000220 MI Practitioner - Physical Medicine and Rehabilitation 5395287841 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Michigan State University College of Osteopathic Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Msu Health Care Inc.Group PAC ID 8628404936, 201 clinicians

Practice addresses (Care Compare)

1200 E Michigan Ave
Suite 520
Lansing, MI 48912-1899
Phone (517) 364-5260

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101027590MIMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward W Sparrow Hospital Association CurrentSince Jul 1, 2025 Accepting new patients
Msu Health Care Inc Current Accepting new patients
Edward W. Sparrow Hospital Association Physical Medicine & Rehabilitation CurrentSince Jul 1, 2025 Accepting new patients
Msu Health Care Inc. CurrentSince Jul 1, 2024 Accepting new patients
Msu Health Care Inc. Physical Medicine & Rehabilitation CurrentSince Jul 1, 2024 Accepting new patients
Edward W. Sparrow Hospital Association Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

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

2900 Hannah Blvd
East Lansing, MI 48823
Phone (517) 336-4520

804 Service Rd
Ste A202
East Lansing, MI 48824
Phone (517) 884-2976

1200 E Michigan Ave
Ste 520
Lansing, MI 48912
Phone (517) 364-5151

1322 E Michigan Ave
Lansing, MI 48912
Phone (517) 364-2157

Interoperability endpoints

  • Direct secure messaging: pvolkov1983622@direct.trinity-health.org
  • Direct secure messaging: pavel.volkov.1@25394.direct.athenahealth.com

Organizations & group practices 6

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": "1589155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1205458452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD STE A202",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "517-884-8701",
            "fax_number": "517-884-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 S HAGADORN RD STE 500",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488236804",
            "telephone_number": "517-884-8701",
            "fax_number": "517-884-8787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 E Michigan Ave Ste 520",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489121899",
            "country_code": "US",
            "telephone_number": "517-364-5260",
            "fax_number": "517-364-5251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VOLKOV",
        "first_name": "PAVEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-11",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "5101027590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

Verify at the official NPI Registry.