Individual provider Active NPI

Joseph S. Kozlowski Jr., D.O.

  • Family Medicine Physician
  • Lansing, MI
National Provider Identifier
1366420432
Registry record updated Aug 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101007058 Issued in MI
Practice address
1003 E Mount Hope Ave
Lansing, MI 48910-1822
Phone
(517) 853-3704
Fax
(517) 853-3701
NPI assigned
Jan 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101007058 MI Primary

Addresses

Primary practice location

1003 E Mount Hope Ave
Lansing, MI 48910-1822

Mailing address

1003 E Mount Hope Ave
Lansing, MI 48910-1822
Phone (517) 853-3704

Other identifiers 2

IdentifierTypeStateIssuer
853338574OtherMIBCBS
1366420432MedicaidMI

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
I20080121000233 MI Practitioner - Family Practice 5395826911 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101007058MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Internal Medicine Associates P.C. Family Medicine CurrentSince Dec 15, 2007 Accepting new patients
Healthtexas Provider Network Family Medicine PastSince Dec 15, 2007 Accepting new patients

Locations

2815 S Pennsylvania Ave
Ste 2
Lansing, MI 48910
Phone (517) 367-5740

2815 S Pennsylvania Ave
Ste 204
Lansing, MI 48910
Phone (517) 267-0200

1003 E Mount Hope Ave
Lansing, MI 48910
Phone (517) 853-3704

3955 Patient Care Dr
Ste A
Lansing, MI 48911
Phone (517) 374-7600

2727 S Pennsylvania Ave
Lansing, MI 48910
Phone (517) 975-3750

3955 Patient Care Dr
Lansing, MI 48911
Phone (517) 374-7600

Interoperability endpoints

  • Direct secure messaging: josephkozlowski@ccmedc.allscriptsdirect.net

Organizations & group practices 2

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": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440720000000",
    "number": "1366420432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 E MOUNT HOPE AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489101822",
            "telephone_number": "517-853-3704",
            "fax_number": "517-853-3701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 E MOUNT HOPE AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489101822",
            "telephone_number": "517-853-3704",
            "fax_number": "517-853-3701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZLOWSKI",
        "first_name": "JOSEPH",
        "middle_name": "S.",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2015-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101007058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "853338574",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366420432",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.