Individual provider Active NPI

Raza Ul Haque, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Lansing, MI
National Provider Identifier
1336197706
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
4301061792 Issued in MI
Practice address
2909 E Grand River Ave Ste 102
Lansing, MI 48912-4335
Phone
(517) 364-8670
Fax
(517) 364-8671
NPI assigned
May 5, 2006
Last updated
Jun 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 4301061792 MI Primary

Addresses

Primary practice location

2909 E Grand River Ave Ste 102
Lansing, MI 48912-4335

Mailing address

804 Service Rd Ste A109B
East Lansing, MI 48824-7015
Phone (517) 351-8377

Other practice location 1

4000 N Michigan Rd
Dimondale, MI 48821-9744
Phone (517) 646-6258

Other practice location 2

2700 Burcham Dr
East Lansing, MI 48823-3898
Phone (517) 351-8377

Other identifiers 2

IdentifierTypeStateIssuer
104619863MedicaidMI
1336197706MedicaidMI

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
I20040903001132 MI Practitioner - Geriatric Medicine 3971579558 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Geriatric Medicine
Education
Other, 1990
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)

5091 Willoughby Rd
Msu Health Care Geriatrics
Holt, MI 48842-1054
Phone (517) 694-2144

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301061792MIMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan State University CurrentSince Sep 1, 2007 Accepting new patients
Michigan State University CurrentSince Sep 1, 2007 Accepting new patients
Edward W Sparrow Hospital Association CurrentSince Oct 8, 2007 Accepting new patients
Msu Health Care Inc. CurrentSince Jul 1, 2020 Accepting new patients
Msu Health Care Inc CurrentSince Jul 1, 2020 Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients
Michigan State University Current Accepting new patients
Diamondale Nursing Care Center, LLC Past Accepting new patients
Msu Health Care Inc. Past Accepting new patients
W.a. Foote Memorial Hospital Past Accepting new patients
Burcham Hills Retirement Center II Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

4000 N Michigan Rd
Dimondale, MI 48821
Phone (517) 646-6258

4650 S Hagadorn Rd
Ste 100
East Lansing, MI 48823
Phone (517) 353-4830

4660 S Hagadorn Rd
Ste 420
East Lansing, MI 48823
Phone (517) 884-6100

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

804 Service Rd
Ste A109B
East Lansing, MI 48824
Phone (517) 884-2976

804 Service Rd
Ste A109F
East Lansing, MI 48824

5091 Willoughby Rd
Holt, MI 48842
Phone (517) 694-2144

1200 E Michigan Ave
Ste 245A
Lansing, MI 48912
Phone (517) 364-5710

1200 E Michigan Ave
Ste 655
Lansing, MI 48912
Phone (517) 267-2460

1210 W Saginaw St
Lansing, MI 48915
Phone (517) 364-7180

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

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

2909 E Grand River Ave
Ste 102
Lansing, MI 48912
Phone (517) 364-8670

800 E Columbia St
Mason, MI 48854
Phone (517) 244-8900

3860 Dobie Rd
Okemos, MI 48864
Phone (517) 349-1050

Interoperability endpoints

  • Direct secure messaging: rhaque3170@sparrowdirecthie.org

Organizations & group practices 11

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 4

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1336197706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD STE A109B",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "517-351-8377",
            "fax_number": "517-351-1738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2909 E GRAND RIVER AVE STE 102",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489124335",
            "telephone_number": "517-364-8670",
            "fax_number": "517-364-8671"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 N Michigan Rd",
            "address_purpose": "LOCATION",
            "city": "Dimondale",
            "state": "MI",
            "postal_code": "488219744",
            "country_code": "US",
            "telephone_number": "517-646-6258",
            "fax_number": "517-646-0320",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2700 Burcham Dr",
            "address_purpose": "LOCATION",
            "city": "East Lansing",
            "state": "MI",
            "postal_code": "488233898",
            "country_code": "US",
            "telephone_number": "517-351-8377",
            "fax_number": "517-351-1738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAQUE",
        "first_name": "RAZA",
        "middle_name": "UL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MI",
            "license": "4301061792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104619863",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336197706",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.