Brian James Tsacoumangos, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5315090741 Issued in MI

Practice address

2900 Hannah Blvd Ste 114
East Lansing, MI 48823-5380

Phone

(517) 364-8080

Fax

(517) 364-8088

NPI assigned

May 6, 2018

Last updated

Apr 1, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: btsacoumangos366534@direct.hfhs.org

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.

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  Medicare reassignment
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  NPD (past)

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

{
    "created_epoch": "1525564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1346739224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5689 FRANCESCA LN",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483165752",
            "telephone_number": "586-295-0734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 HANNAH BLVD STE 114",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488235380",
            "telephone_number": "517-364-8080",
            "fax_number": "517-364-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSACOUMANGOS",
        "first_name": "BRIAN",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-06",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5315090741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346739224",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alison Lee Trout, LLPC
• Erin Cecilia Trowbridge
• Troy Gastroenterology, PC (Michigan Gastroenterology Institute)
• Heather M Trudeau, PA
• Trunorth Integrated Therapy, PLLC
• Wan Chong Tsai, MD
• Martin J Tuck, DDS, MS
• Lakeeya K Tucker, DO
• Nancy Tucker, P.T.
• Mohammad Tuleimat, MD

• Physician Assistant in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.