NPIMap

Individual provider Active NPI

Manel Boumegouas, MD

  • Cardiovascular Disease Physician
  • Lansing, MI
National Provider Identifier
1548748122
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
4301512554 Issued in MI
Practice address
1215 E Michigan Ave
Lansing, MI 48912-1811
Phone
(517) 364-1000
NPI assigned
Aug 5, 2018
Last updated
May 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 4301512554 MI Primary
Internal Medicine Physician 207R00000X 4301116264 MI

Addresses

Primary practice location

1215 E Michigan Ave
Lansing, MI 48912-1811

Mailing address

3806 Cornice Falls Dr Apt 7
Holt, MI 48842-8809
Phone (248) 820-2024

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241119001620 MI Practitioner - Cardiovascular Disease (Cardiology) 8022543784 Reassigns benefits to 2 organizations
I20241202001018 OH Practitioner - Cardiovascular Disease (Cardiology) 8022543784 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Northwest Ohio Cardiology Consultants LLCGroup PAC ID 4981752938, shared by 2 NPIs, 84 clinicians

Practice addresses (Care Compare)

1140 E Michigan Ave
400 Sparrow Tci
Lansing, MI 48912-1806
Phone (517) 364-9650

2940 N McCord Rd
Toledo, OH 43615-1753
Phone (419) 842-3000

730 N Macomb St
Suite 228
Monroe, MI 48162-3087
Phone (734) 242-7060

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301116264MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Northwest Ohio Cardiology Consultants, LLC Cardiovascular Disease CurrentSince Sep 13, 2024 Accepting new patients
Promedica Northwest Ohio Cardiology Consultants Cardiovascular Disease CurrentSince Sep 13, 2024 Accepting new patients

Locations

770 Riverside Ave
Ste 106
Adrian, MI 49221
Phone (517) 266-0525

730 N Macomb St
Ste 228
Monroe, MI 48162
Phone (734) 242-7060

1037 Conneaut Ave
Ste 202
Bowling Green, OH 43402
Phone (419) 354-0104

2940 N McCord Rd
Toledo, OH 43615
Phone (419) 842-3000

2940 N McCord Rd
#100
Toledo, OH 43615
Phone (419) 842-3000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1533427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1548748122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3806 CORNICE FALLS DR APT 7",
            "city": "HOLT",
            "state": "MI",
            "postal_code": "488428809",
            "telephone_number": "248-820-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 E MICHIGAN AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121811",
            "telephone_number": "517-364-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUMEGOUAS",
        "first_name": "MANEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-05",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301512554",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301116264",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.