Individual provider Active NPI

Shumin Zhao, MD

  • Psychiatry Physician
  • Lansing, MI
National Provider Identifier
1306941570
Registry record updated Jan 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301068374 Issued in MI
Practice address
1210 W Saginaw St
2ND Floor
Lansing, MI 48915-1927
Phone
(517) 364-7700
Fax
(517) 364-7701
NPI assigned
Sep 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4301068374 MI Primary

Addresses

Primary practice location

1210 W Saginaw St
2ND Floor
Lansing, MI 48915-1927

Mailing address

PO Box 13008
Lansing, MI 48901-3008
Phone (517) 364-6253

Other identifiers 2

IdentifierTypeStateIssuer
4238651MedicaidMI
2603307082OtherMIBCBS INDIVIDUAL PIN

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
I20070703000374 MI Practitioner - Psychiatry 1557461613 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301068374MIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward W Sparrow Hospital Association CurrentSince Oct 2, 2000 Accepting new patients
Edward W. Sparrow Hospital Association Psychiatry CurrentSince Oct 2, 2000 Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

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

1210 W Saginaw St
Fl 2
Lansing, MI 48915
Phone (517) 364-7575

1200 E Michigan Ave
Ste 530
Lansing, MI 48912
Phone (517) 364-5880

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.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199232000000",
    "number": "1306941570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13008",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489013008",
            "telephone_number": "517-364-6253",
            "fax_number": "517-364-6204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 W SAGINAW ST",
            "address_2": "2ND FLOOR",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489151927",
            "telephone_number": "517-364-7700",
            "fax_number": "517-364-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZHAO",
        "first_name": "SHUMIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2008-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301068374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4238651",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL PIN",
            "identifier": "2603307082",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.