Individual provider Active NPI

Jonathan Andrew Altman, MD

  • Family Medicine Physician
  • Lansing, MI
National Provider Identifier
1457327827
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301078741 Issued in MI
Practice address
3960 Patient Care Dr
Ste 108
Lansing, MI 48911-4276
Phone
(517) 394-8589
Fax
(517) 394-8594
NPI assigned
Feb 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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 4301078741 MI Primary

Addresses

Primary practice location

3960 Patient Care Dr
Ste 108
Lansing, MI 48911-4276

Mailing address

3960 Patient Care Dr
Ste 108
Lansing, MI 48911-4276
Phone (516) 855-5255

Other identifiers 1

IdentifierTypeStateIssuer
1457327827MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20250124000077 TN Order and Referring Only - Family PracticePractitioner - Family Practice 5193777373

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ingham Nephrology and Hypertension PC PastSince Mar 9, 2020 Accepting new patients
St Johns Family Health Center, PLLC Family Medicine Past Accepting new patients
Sparrow Eaton Hospital Past Accepting new patients
Altman Family Practice Family Medicine PastSince Jun 4, 2012 Accepting new patients

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": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1457327827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3960 PATIENT CARE DR",
            "address_2": "STE 108",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489114276",
            "telephone_number": "516-855-5255",
            "fax_number": "516-921-2451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3960 PATIENT CARE DR",
            "address_2": "STE 108",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489114276",
            "telephone_number": "517-394-8589",
            "fax_number": "517-394-8594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTMAN",
        "first_name": "JONATHAN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301078741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457327827",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.