Individual provider Active NPI

Fred Isaacs, M.D.

  • Internal Medicine Physician
  • Lansing, MI
National Provider Identifier
1487609665
Registry record updated Sep 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301049674 Issued in MI
Practice address
1540 Lake Lansing Rd
Ste 201
Lansing, MI 48912-3756
Phone
(517) 913-3900
Fax
(517) 913-3901
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301049674 MI Primary

Addresses

Primary practice location

1540 Lake Lansing Rd
Ste 201
Lansing, MI 48912-3756

Mailing address

1540 Lake Lansing Rd
Ste 201
Lansing, MI 48912-3756
Phone (517) 913-3900

Other identifiers 11

IdentifierTypeStateIssuer
1001087OtherMIMCLAREN HEALTH ADVANTAGE
1001087OtherMIMCLAREN HEALTH PLAN-MEDICAID
200000002148OtherMIPHP
4848140MedicaidMI
1001087OtherMIMCLAREN HEALTH PLAN-COMMERCIAL
110119711OtherMIRAILROAD MEDICARE
200000002148OtherMIPHP FAMILYCARE
4083594MedicaidMI
0M21440002OtherMIMEDICARE PLUS BLUE
1103315702OtherMIBCBS/BCN
4453082OtherMIAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253577600000",
    "number": "1487609665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 LAKE LANSING RD",
            "address_2": "STE 201",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489123756",
            "telephone_number": "517-913-3900",
            "fax_number": "517-913-3901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 LAKE LANSING RD",
            "address_2": "STE 201",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489123756",
            "telephone_number": "517-913-3900",
            "fax_number": "517-913-3901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISAACS",
        "first_name": "FRED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2009-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301049674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN HEALTH ADVANTAGE",
            "identifier": "1001087",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN HEALTH PLAN-MEDICAID",
            "identifier": "1001087",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "200000002148",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4848140",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN HEALTH PLAN-COMMERCIAL",
            "identifier": "1001087",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110119711",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP FAMILYCARE",
            "identifier": "200000002148",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4083594",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PLUS BLUE",
            "identifier": "0M21440002",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS/BCN",
            "identifier": "1103315702",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4453082",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.