Individual provider Active NPI

Angelina M Iafano, DO

  • Neuromusculoskeletal Medicine & OMM Physician
  • East Lansing, MI
National Provider Identifier
1336714054
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
5101027193 Issued in MI
Practice address
4660 S Hagadorn Rd Ste 500
East Lansing, MI 48823-6804
Phone
(517) 432-6144
Fax
(517) 432-6150
NPI assigned
May 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 5101027193 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) 432-6144

Other practice location 1

1215 E Michigan Ave
Lansing, MI 48912-1811
Phone (517) 364-1000

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
I20240716001670 MI Practitioner - Osteopathic Manipulative Medicine 2062957954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
Michigan State University College of Osteopathic Medicine, 2021
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)

4660 S Hagadorn Rd
Suite 500
East Lansing, MI 48823-6804
Phone (517) 884-4554

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101027193MIMDNeuromusculoskeletal Medicine & OMM Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Msu Health Care Inc. CurrentSince Aug 1, 2024 Accepting new patients
Msu Health Care Inc Current Accepting new patients
Msu Health Care Inc. CurrentSince Aug 1, 2024 Accepting new patients
Msu Health Care Inc. Past Accepting new patients

Locations

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

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

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

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

Interoperability endpoints

  • Direct secure messaging: angelina.iafano.1@25394.direct.athenahealth.com

Organizations & group practices 4

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": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1336714054",
    "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": "517-432-6144",
            "fax_number": "517-432-6150"
        },
        {
            "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": "517-432-6144",
            "fax_number": "517-432-6150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 E Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489121811",
            "country_code": "US",
            "telephone_number": "517-364-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IAFANO",
        "first_name": "ANGELINA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-25",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "MI",
            "license": "5101027193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

Verify at the official NPI Registry.