Individual provider Active NPI

Mary Pugmire, DO

  • Obstetrics & Gynecology Physician
  • Lansing, MI
National Provider Identifier
1508964701
Registry record updated Sep 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
5101013713 Issued in MI
Practice address
1200 E Michigan Ave
Ste 445
Lansing, MI 48912-1800
Phone
(517) 364-5210
Fax
(517) 364-5216
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 5101013713 MI Primary

Addresses

Primary practice location

1200 E Michigan Ave
Ste 445
Lansing, MI 48912-1800

Mailing address

PO Box 13008
Lansing, MI 48901-3008
Phone (517) 364-6253

Other identifiers 4

IdentifierTypeStateIssuer
4310807MedicaidMI
1653301715OtherMIBCBS INDIVIDUAL PIN
200000002556OtherMIPHP PIN #
3456253MedicaidMI

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
I20111107000097 MI Practitioner - Obstetrics/Gynecology 7517130693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
R Franklin University of Med & Sci/Chicago Medical School, 1990
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)

1200 E Michigan Ave
Lansing, MI 48912-1897

1200 E Michigan Ave Lowr Level
Sparrow Pain Management Center
Lansing, MI 48912-1800
Phone (517) 364-5330

1215 E Michigan Ave
Lansing, MI 48912-1811

1600 W Grand River Ave
Okemos, MI 48864-2394

Hospital & facility affiliations

  • Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101013713MIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward W. Sparrow Hospital Association Current Accepting new patients
Edward W Sparrow Hospital Association CurrentSince Jan 1, 2000 Accepting new patients
Edward W. Sparrow Hospital Association Obstetrics & Gynecology CurrentSince Jan 1, 2000 Accepting new patients
Edward W. Sparrow Hospital Association Past Accepting new patients
Edward W Sparrow Hospital Association Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

1651 W Lake Lansing Rd
Ste 300
East Lansing, MI 48823
Phone (517) 253-3910

1200 E Michigan Ave
Ste 325
Lansing, MI 48912
Phone (517) 364-5160

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

1200 E Michigan Ave
Ste 445
Lansing, MI 48912
Phone (517) 364-5210

1600 W Grand River Ave
Ste 1
Okemos, MI 48864
Phone (517) 381-6870

Interoperability endpoints

  • Direct secure messaging: mpugmire1662@sparrowdirecthie.org

Organizations & group practices 5

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 2

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316736000000",
    "number": "1508964701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13008",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489013008",
            "telephone_number": "517-364-6253",
            "fax_number": "517-364-6204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E MICHIGAN AVE",
            "address_2": "STE 445",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121800",
            "telephone_number": "517-364-5210",
            "fax_number": "517-364-5216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGMIRE",
        "first_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2011-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "5101013713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4310807",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL PIN",
            "identifier": "1653301715",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP PIN #",
            "identifier": "200000002556",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3456253",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.