Individual provider Active NPI

Ajovi B Scott Emuakpor, MD PHD

  • Pediatric Hematology & Oncology Physician
  • East Lansing, MI
National Provider Identifier
1376571000
Registry record updated May 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
4301039172 Issued in MI
Practice address
804 Service Road
Room B240
East Lansing, MI 48824-7041
Phone
(517) 355-8998
Fax
(517) 355-8312
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301039172 MI
Pediatric Hematology & Oncology Physician 2080P0207X 4301039172 MI Primary

Addresses

Primary practice location

804 Service Road
Room B240
East Lansing, MI 48824-7041

Mailing address

1200 E Michigan Ave
Suite 145 - Msu Pediatric Sub-Specialty Clinics
Lansing, MI 48912-1800
Phone (517) 364-5440

Other identifiers 1

IdentifierTypeStateIssuer
1376571000MedicaidMI

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
I20040723000963 MI Practitioner - Hematology/OncologyPractitioner - General PracticePractitioner - Pediatric Medicine 9335129881 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: General Practice, Pediatric Medicine
Education
Michigan State University College of Human Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2108 4TH St a
Jackson, MI 49203-4518
Phone (517) 788-9700

Hospital & facility affiliations

  • Elara Caring Home health agency, Jackson, MI, CCN 237274
  • Mid Michigan Home Health Care Home health agency, Flint, MI, CCN 237704
  • Promedica Charles and Virginia Hickman Hospital Hospital, Adrian, MI, CCN 230005
  • Henry Ford Allegiance Health Hospital, Jackson, MI, CCN 230092

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan State University Hematology & Oncology Current Accepting new patients
Michigan State University CurrentSince Apr 1, 1988 Accepting new patients
Capital Area Pathologists, PC Current Accepting new patients
Msu Health Care Inc. CurrentSince Jul 1, 2020 Accepting new patients
Edward W Sparrow Hospital Association CurrentSince Dec 19, 2021 Accepting new patients
Michigan State University Current Accepting new patients
Michigan State University CurrentSince Apr 1, 1988 Accepting new patients
Edward W. Sparrow Hospital Association Pediatrics CurrentSince Dec 19, 2021 Accepting new patients
Michigan State University Current Accepting new patients
Msu Health Care Inc CurrentSince Jul 1, 2020 Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

406 E Elm St
Carson City, MI 48811
Phone (517) 584-3131

804 Service Rd
Ste A109F
East Lansing, MI 48824

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

4660 S Hagadorn Rd
Ste 405
East Lansing, MI 48823
Phone (517) 884-8600

1200 E Michigan Ave
Ste 460
Lansing, MI 48912
Phone (517) 364-2097

401 W Greenlawn Ave
Lansing, MI 48910
Phone (517) 334-2286

1200 E Michigan Ave
Ste 145
Lansing, MI 48912
Phone (517) 364-5440

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

Interoperability endpoints

  • Direct secure messaging: ajovi.scott-emuakpor.1@25394.direct.athenahealth.com

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 and National Provider Directory roles.

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336348800000",
    "number": "1376571000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E MICHIGAN AVE",
            "address_2": "SUITE 145 - MSU PEDIATRIC SUB-SPECIALTY CLINICS",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121800",
            "telephone_number": "517-364-5440",
            "fax_number": "517-364-5413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 SERVICE ROAD",
            "address_2": "ROOM B240",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247041",
            "telephone_number": "517-355-8998",
            "fax_number": "517-355-8312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT EMUAKPOR",
        "first_name": "AJOVI",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD  PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2012-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301039172",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "MI",
            "license": "4301039172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376571000",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

Verify at the official NPI Registry.