Individual provider Active NPI

Elizabeth Paine, D.O

  • Internal Medicine Physician
  • Grand Ledge, MI
National Provider Identifier
1679929343
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101024846 Issued in MI
Practice address
1035 Charlevoix Dr Ste 100
Grand Ledge, MI 48837-2223
Phone
(517) 627-2181
Fax
(517) 622-1242
NPI assigned
May 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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 5101024846 MI Primary

Addresses

Primary practice location

1035 Charlevoix Dr Ste 100
Grand Ledge, MI 48837-2223

Mailing address

425 W 5TH St
Medical Education
East Liverpool, OH 43920-2405
Phone (330) 386-2793

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
I20190822001458 MI Practitioner - Internal Medicine 9537497987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
David J. Smith MD PCGroup PAC ID 2567431729, 16 clinicians

Practice addresses (Care Compare)

1035 Charlevoix Dr
Suite 100
Grand Ledge, MI 48837-2223
Phone (517) 627-2181

Hospital & facility affiliations

  • Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230
  • McLaren Greater Lansing Hospital, Lansing, MI, CCN 230167
  • University of Michigan Health - Sparrow Eaton Hospital, Charlotte, MI, CCN 231327
  • Sparrow Ionia Hospital Hospital, Ionia, MI, CCN 231331

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
David J. Smith MD PC CurrentSince Sep 16, 2019 Accepting new patients

Locations

1035 Charlevoix Dr
Ste 100
Grand Ledge, MI 48837
Phone (517) 622-6446

Interoperability endpoints

  • Direct secure messaging: epaine@fmom.directbygreenway.com

Organizations & group practices 1

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 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": "1462924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1679929343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 W 5TH ST",
            "address_2": "MEDICAL EDUCATION",
            "city": "EAST LIVERPOOL",
            "state": "OH",
            "postal_code": "439202405",
            "telephone_number": "330-386-2793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 CHARLEVOIX DR STE 100",
            "city": "GRAND LEDGE",
            "state": "MI",
            "postal_code": "488372223",
            "telephone_number": "517-627-2181",
            "fax_number": "517-622-1242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAINE",
        "first_name": "ELIZABETH",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-11",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101024846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Ledge, MI

Sources for this page

Verify at the official NPI Registry.