Individual provider Active NPI

Subhashis Mitra, M.D.

  • Infectious Disease Physician
  • East Lansing, MI
National Provider Identifier
1679763973
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
4301095914 Issued in MI
Practice address
4650 S Hagadorn Rd Ste 100
East Lansing, MI 48823-5386
Phone
(517) 353-4830
Fax
(517) 355-2134
NPI assigned
Aug 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 4301095914 MI Primary

Addresses

Primary practice location

4650 S Hagadorn Rd Ste 100
East Lansing, MI 48823-5386

Mailing address

804 Service Rd Ste A109B
East Lansing, MI 48824-7015
Phone (517) 353-4830

Other identifiers 1

IdentifierTypeStateIssuer
1679763973MedicaidMI

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
I20120712000681 MI Practitioner - Infectious Disease 1557526761 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Msu Health Care Inc.Group PAC ID 8628404936, 201 clinicians

Practice addresses (Care Compare)

4650 S Hagadorn Rd
Suite 100
East Lansing, MI 48823-5386
Phone (517) 353-4830

Hospital & facility affiliations

  • Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230
  • McLaren Greater Lansing Hospital, Lansing, MI, CCN 230167

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301095914MIMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Msu Health Care Inc CurrentSince Jul 1, 2020 Accepting new patients
Michigan State University Current Accepting new patients
Michigan State University Internal Medicine Current Accepting new patients
Michigan State University CurrentSince May 1, 2012 Accepting new patients
Capital Area Pathologists, PC Current Accepting new patients
Michigan State University Infectious Disease CurrentSince May 1, 2012 Accepting new patients
Msu Health Care Inc. CurrentSince Jul 1, 2020 Accepting new patients
Msu Health Care Inc. Past Accepting new patients

Locations

4650 S Hagadorn Rd
Ste 100
East Lansing, MI 48823
Phone (517) 353-4830

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

4660 S Hagadorn Rd
Ste 500
East Lansing, MI 48823
Phone (517) 432-6144

804 Service Rd
Ste A109B
East Lansing, MI 48824
Phone (517) 884-2976

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

1200 E Michigan Ave
Ste 655
Lansing, MI 48912
Phone (517) 267-2460

Interoperability endpoints

  • Direct secure messaging: subhashis.mitra.1@25394.direct.athenahealth.com

Organizations & group practices 8

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 3

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": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1679763973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD STE A109B",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "517-353-4830",
            "fax_number": "517-355-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 S HAGADORN RD STE 100",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488235386",
            "telephone_number": "517-353-4830",
            "fax_number": "517-355-2134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITRA",
        "first_name": "SUBHASHIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-01",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MI",
            "license": "4301095914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679763973",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

Verify at the official NPI Registry.