Individual provider Active NPI

Alireza Mofid, MD

  • Vascular Surgery Physician
  • Lansing, MI
National Provider Identifier
1366998619
Registry record updated Jul 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
4301507973 Issued in MI
Practice address
1140 E Michigan Ave Ste 300
Lansing, MI 48912-1806
Phone
(517) 364-5200
NPI assigned
Aug 28, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2023 MD
Vascular Surgery Physician 2086S0129X 4301507973 MI Primary

Addresses

Primary practice location

1140 E Michigan Ave Ste 300
Lansing, MI 48912-1806

Mailing address

1140 E Michigan Ave Ste 300
Lansing, MI 48912-1806
Phone (517) 364-5200

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
I20230614001574 MI Practitioner - General SurgeryPractitioner - Vascular Surgery 8426346164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Vascular Surgery
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edward W Sparrow Hospital AssociationGroup PAC ID 6709799166, 698 clinicians

Practice addresses (Care Compare)

1140 E Michigan Ave
Lansing, MI 48912-1806

1200 E Michigan Ave
Lansing, MI 48912-1838

1215 E Michigan Ave
Lansing, MI 48912-1811

300 Health Park Dr
Suite 301
Owosso, MI 48867-1293
Phone (989) 723-3613

321 E Harris St
Charlotte, MI 48813-1629

Hospital & facility affiliations

  • Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230
  • University of Michigan Health - Sparrow Eaton Hospital, Charlotte, MI, CCN 231327
  • University of Michigan Health- Sparrow Clinton Hospital, Saint Johns, MI, CCN 231326
  • Sparrow Ionia Hospital Hospital, Ionia, MI, CCN 231331

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2023MDMDSurgery Physician
4301507973MIMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward W Sparrow Hospital Association CurrentSince Aug 1, 2023 Accepting new patients
Edward W. Sparrow Hospital Association CurrentSince Aug 1, 2023 Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients
Edward W Sparrow Hospital Association Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

1200 E Michigan Ave
Ste 775
Lansing, MI 48912
Phone (517) 364-5160

1140 E Michigan Ave
Ste 300
Lansing, MI 48912
Phone (517) 364-5200

1215 E Michigan Ave
#8W
Lansing, MI 48912
Phone (517) 364-2614

1140 E Michigan Ave
Ste 400
Lansing, MI 48912
Phone (517) 483-7550

Interoperability endpoints

  • Direct secure messaging: amofid103215@sparrowdirecthie.org

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.

Hospital & facility affiliations 7

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": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688774400000",
    "number": "1366998619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 E MICHIGAN AVE STE 300",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121806",
            "telephone_number": "517-364-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 E MICHIGAN AVE STE 300",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121806",
            "telephone_number": "517-364-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFID",
        "first_name": "ALIREZA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-28",
        "last_updated": "2023-07-08",
        "certification_date": "2023-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "2023",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MI",
            "license": "4301507973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.