NPIMap

Organization Active NPI

Edward W Sparrow Hospital Association

Doing business as Heart and Vascular Center - Interventional Radiology Department

  • Vascular & Interventional Radiology Physician
  • Lansing, MI
National Provider Identifier
1629517420
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
1060000091 Issued in MI
Legal business name
EDWARD W SPARROW HOSPITAL ASSOCIATION
Doing business as
Heart and Vascular Center - Interventional Radiology Department
University of Michigan Health-Sparrow Interventional Radiology
Practice address
1215 E Michigan Ave
West Tower 4TH Floor
Lansing, MI 48912-1811
Phone
(517) 364-3480
Fax
(517) 364-3270
NPI assigned
Feb 14, 2017
Last updated
Mar 27, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
SPARROW HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Authorized official

Name
Misty Gunter Russian
Title
Supervisor, Provider Enrollment
Phone
(517) 253-6308

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 1060000091 MI Primary

Addresses

Primary practice location

1215 E Michigan Ave
West Tower 4TH Floor
Lansing, MI 48912-1811

Mailing address

8175 Reliable Pkwy
Chicago, IL 60686-0081
Phone (517) 364-3480

Other names 2

  • Heart and Vascular Center - Interventional Radiology Department Doing business as
  • University of Michigan Health-Sparrow Interventional Radiology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170222001286 MI Part B Supplier - Clinic/Group Practice 6709799166 Receives reassigned benefits from 119 practitioners
2 other NPIs on this enrollment
Practice locations: Lansing, MI; Mason, MI; Okemos, MI; Portland, MI; Saint Johns, MI; Saranac, MI; St Johns, MI; Charlotte, MI…

Other NPIs with the same Medicare PAC ID 19

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 19

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Sparrow Health System

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1140 E Michigan Ave
Ste 400
Lansing, MI 48912
Phone (517) 483-7550

1200 E Michigan Ave
Fl 1
Lansing, MI 48912

Practitioners & affiliated clinicians

Practitioners 119

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 119

NPI Registry JSON

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

{
    "created_epoch": "1487030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1629517420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8175 RELIABLE PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606860081",
            "telephone_number": "517-364-3480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 E MICHIGAN AVE",
            "address_2": "WEST TOWER 4TH FLOOR",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121811",
            "telephone_number": "517-364-3480",
            "fax_number": "517-364-3270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD W SPARROW HOSPITAL ASSOCIATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPARROW HEALTH SYSTEM",
        "enumeration_date": "2017-02-14",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A",
        "authorized_official_last_name": "RUSSIAN",
        "authorized_official_first_name": "MISTY",
        "authorized_official_middle_name": "GUNTER",
        "authorized_official_title_or_position": "SUPERVISOR, PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "517-253-6308"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MI",
            "license": "1060000091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heart and Vascular Center - Interventional Radiology Department",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "University of Michigan Health-Sparrow Interventional Radiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.