Individual provider Active NPI

John Paul Kepros, M.D.

  • Surgery Physician
  • Lansing, MI
National Provider Identifier
1487665519
Registry record updated Aug 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4301059421 Issued in MI
Practice address
Sparrow Hospital - Trauma Services
1215 E Michigan Ave
Lansing, MI 48912
Phone
(517) 267-2460
Fax
(517) 267-2462
NPI assigned
Aug 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4301059421 MI Primary

Addresses

Primary practice location

Sparrow Hospital - Trauma Services
1215 E Michigan Ave
Lansing, MI 48912

Mailing address

804 Service Rd
# A109F
East Lansing, MI 48824-7015
Phone (517) 884-2976

Other identifiers 1

IdentifierTypeStateIssuer
4579660MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20191001001582 AZ Practitioner - General Surgery 2163327768 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301059421MIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Honorhealth Ambulatory CurrentSince Aug 19, 2019 Accepting new patients
Honorhealth Ambulatory CurrentSince Aug 19, 2019 Accepting new patients
Honorhealth Ambulatory Current Accepting new patients
Mile High Surgical Specialists, PC Past Accepting new patients

Locations

2500 W Utopia Rd
Ste 100
Phoenix, AZ 85027
Phone (623) 683-4462

10510 N 92nd St
Ste 200
Scottsdale, AZ 85258
Phone (480) 323-1250

7351 E Osborn Rd
Ste 200B
Scottsdale, AZ 85251
Phone (480) 882-5730

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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1487665519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD",
            "address_2": "# A109F",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "517-884-2976",
            "fax_number": "517-432-3928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SPARROW HOSPITAL - TRAUMA SERVICES",
            "address_2": "1215 E MICHIGAN AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "48912",
            "telephone_number": "517-267-2460",
            "fax_number": "517-267-2462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEPROS",
        "first_name": "JOHN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301059421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4579660",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.