NPIMap

Individual provider Active NPI

Jerome F. Cordes, M.D.

  • Diagnostic Radiology Physician
  • Lansing, MI
National Provider Identifier
1336176106
Registry record updated Sep 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4301050298 Issued in MI
Practice address
1215 E Michigan Ave
Lansing, MI 48912-1811
Phone
(517) 364-2315
Fax
(517) 372-1617
NPI assigned
Jun 27, 2006
Last updated
Sep 24, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 4301050298 MI Primary

Addresses

Primary practice location

1215 E Michigan Ave
Lansing, MI 48912-1811

Mailing address

3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Phone (616) 363-7339

Other identifiers 3

IdentifierTypeStateIssuer
1600055OtherMIPHP
3003321021OtherMIBCBS MI INDIVIDUAL PIN
2670938MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031222000251 MI Practitioner - Diagnostic Radiology 4789582453 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Michigan State University College of Human Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1215 E Michigan Ave
Unitversity of Michigan Health Spar
Lansing, MI 48912-1811
Phone (517) 364-5650

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301050298MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward W Sparrow Hospital Association CurrentSince Jul 1, 2024 Accepting new patients
Edward W Sparrow Hospital Association CurrentSince Jul 1, 2024 Accepting new patients
Edward W Sparrow Hospital Association Current Accepting new patients
Lansing Radiology Associates P C Diagnostic Radiology CurrentSince Jan 1, 1979 Accepting new patients
Edward W. Sparrow Hospital Association Past Accepting new patients
Memorial Hospital Past Accepting new patients

Locations

4748 Reliable Pkwy
Chicago, IL 60686

8175 Reliable Pkwy
Chicago, IL 60686

406 E Elm St
Carson City, MI 48811
Phone (517) 584-3131

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

271 Woodland Pass
Ste 120
East Lansing, MI 48823
Phone (517) 351-4905

3264 N Evergreen Dr NE
Grand Rapids, MI 49525
Phone (616) 391-6001

1200 E Michigan Ave
Fl 1
Lansing, MI 48912

1200 E Michigan Ave
Ste 500
Lansing, MI 48912
Phone (517) 364-5123

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

1215 E Michigan Ave
Fl 4
Lansing, MI 48912
Phone (517) 364-3480

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

114 W North St
Owosso, MI 48867
Phone (989) 723-5211

805 S Oakland St
Saint Johns, MI 48879
Phone (989) 224-6881

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

Hospital & facility affiliations 8

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253750400000",
    "number": "1336176106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3264 N EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259746",
            "telephone_number": "616-363-7339",
            "fax_number": "616-361-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 E MICHIGAN AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121811",
            "telephone_number": "517-364-2315",
            "fax_number": "517-372-1617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDES",
        "first_name": "JEROME",
        "middle_name": "F.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2009-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301050298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "1600055",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MI INDIVIDUAL PIN",
            "identifier": "3003321021",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2670938",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.