Individual provider Active NPI

Bhagya Mysore Venkatesh, M.D

  • Pediatrics Physician
  • Lansing, MI
National Provider Identifier
1679882005
Registry record updated Oct 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301097216 Issued in MI
Practice address
901 East Michigan Avenue
Lansing, MI 48910
Phone
(517) 485-1153
NPI assigned
Oct 4, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301097216 MI Primary

Addresses

Primary practice location

901 East Michigan Avenue
Lansing, MI 48910

Mailing address

901 East Michigan Avenue
Lansing, MI 48910
Phone (517) 485-1153

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
I20130821000121 MI Practitioner - Pediatric Medicine 1759524853 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301097216MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward W Sparrow Hospital Association CurrentSince Jun 1, 2013 Accepting new patients
Edward W. Sparrow Hospital Association Pediatrics Current Accepting new patients
Sparrow Ionia Hospital Current Accepting new patients
Edward W. Sparrow Hospital Association CurrentSince Jun 1, 2013 Accepting new patients
Sparrow Eaton Hospital CurrentSince Apr 10, 2024 Accepting new patients
Sparrow Ionia Hospital CurrentSince Jul 1, 2013 Accepting new patients
Sparrow Ionia Hospital CurrentSince Jul 1, 2013 Accepting new patients
Sparrow Eaton Hospital CurrentSince Apr 10, 2024 Accepting new patients
Sparrow Eaton Hospital Current Accepting new patients
Sparrow Ionia Hospital Pediatrics Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

123 Lansing St
Ste 2
Charlotte, MI 48813
Phone (517) 541-5954

111 Lansing St
Ste 110
Charlotte, MI 48813
Phone (517) 541-5855

509 Burcham Dr
Ste 59
East Lansing, MI 48823
Phone (517) 333-7500

820 Spring St
Ste 100
Grand Ledge, MI 48837
Phone (517) 925-5590

550 E Washington St
Ionia, MI 48846
Phone (616) 523-1600

1200 E Michigan Ave
Ste 460
Lansing, MI 48912
Phone (517) 364-2097

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

800 E Columbia St
Mason, MI 48854
Phone (517) 244-8900

1850 Hyland Dr
Portland, MI 48875
Phone (517) 253-5084

Interoperability endpoints

  • Direct secure messaging: bmysorevenkatesh3681@sparrowdirecthie.org

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1286150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286150400000",
    "number": "1679882005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 EAST MICHIGAN AVENUE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "48910",
            "telephone_number": "517-485-1153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 EAST MICHIGAN AVENUE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "48910",
            "telephone_number": "517-485-1153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYSORE VENKATESH",
        "first_name": "BHAGYA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-04",
        "last_updated": "2010-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301097216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.