NPIMap

Individual provider Active NPI

Michael Casmir Kowalczyk, DO

  • Internal Medicine Physician
  • Lansing, MI
National Provider Identifier
1649277211
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MK010436 Issued in MI
Practice address
3955 Patient Care Dr Ste a
Lansing, MI 48911-4271
Phone
(517) 374-7600
Fax
(885) 480-9150
NPI assigned
Jun 28, 2005
Reactivated
Mar 28, 2006
Last updated
Mar 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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 MK010436 MI Primary

Addresses

Primary practice location

3955 Patient Care Dr Ste a
Lansing, MI 48911-4271

Mailing address

3955 Patient Care Dr Ste a
Lansing, MI 48911-4271
Phone (517) 374-7600

Other identifiers 1

IdentifierTypeStateIssuer
2901730-11MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040722001237 MI Practitioner - Internal Medicine 0244219194 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Michigan State University College of Osteopathic Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eaton Rapids Medical CenterGroup PAC ID 5991692634, shared by 4 NPIs, 34 clinicians
Capital Internal Medicine Associates P.C.Group PAC ID 8022097963, 64 clinicians

Practice addresses (Care Compare)

1500 S Main St
Ermc Family Practice and Redicare
Eaton Rapids, MI 48827-1952
Phone (517) 999-4500

3955 Patient Care Dr
Lansing, MI 48911-4299
Phone (517) 374-7600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MK010436MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eaton Rapids Medical Center CurrentSince Jan 13, 2022 Accepting new patients
Eaton Rapids Medical Center CurrentSince Jan 13, 2022 Accepting new patients
Eaton Rapids Medical Center Current Accepting new patients
Capital Internal Medicine Associates P.C. Internal Medicine CurrentSince Nov 1, 1987 Accepting new patients
McLaren Greater Lansing Past Accepting new patients
Eaton Rapids Medical Center Past Accepting new patients

Locations

1500 S Main St
Eaton Rapids, MI 48827
Phone (517) 663-2671

1003 E Mount Hope Ave
Lansing, MI 48910
Phone (517) 853-3704

3937 Patient Care Dr
Ste 104
Lansing, MI 48911
Phone (517) 374-4202

3955 Patient Care Dr
Lansing, MI 48911
Phone (517) 374-7600

3955 Patient Care Dr
Ste A
Lansing, MI 48911
Phone (517) 374-7600

401 W Greenlawn Ave
Lansing, MI 48910
Phone (517) 334-2286

Interoperability endpoints

  • Direct secure messaging: michael.kowalczyk@cimamed.eclinicaldirectplus.com

Organizations & group practices 6

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 11

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": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1649277211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3955 PATIENT CARE DR STE A",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489114271",
            "telephone_number": "517-374-7600",
            "fax_number": "885-480-9150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3955 PATIENT CARE DR STE A",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489114271",
            "telephone_number": "517-374-7600",
            "fax_number": "885-480-9150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALCZYK",
        "first_name": "MICHAEL",
        "middle_name": "CASMIR",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "deactivation_date": "2006-03-17",
        "reactivation_date": "2006-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "MK010436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2901730-11",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.