Individual provider Active NPI

Lionel W Rosen, M.D.

  • Psychiatry Physician
  • East Lansing, MI
National Provider Identifier
1689658056
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301029268 Issued in MI
Practice address
909 Fee Road Room B119
East Lansing, MI 48824-3603
Phone
(517) 353-3070
Fax
(517) 432-3603
NPI assigned
Nov 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4301029268 MI Primary

Addresses

Primary practice location

909 Fee Road Room B119
East Lansing, MI 48824-3603

Mailing address

804 Service Rd # A109B
East Lansing, MI 48824-7015
Phone (517) 884-2976

Other identifiers 1

IdentifierTypeStateIssuer
1689658056MedicaidMI

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
I20100819000169 MI Practitioner - Psychiatry 3476687930 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Jefferson Medical College of Thomas Jefferson University, 1965
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)

909 Wilson Rd
Suite B119
East Lansing, MI 48824-6410
Phone (517) 353-3070

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan State University Psychiatry CurrentSince Nov 1, 2016 Accepting new patients
Michigan State University CurrentSince Nov 1, 2016 Accepting new patients
Michigan State University Psychiatry Current Accepting new patients
Msu Health Care Inc. CurrentSince Jul 1, 2020 Accepting new patients
Msu Health Care Inc CurrentSince Jul 1, 2020 Accepting new patients
Michigan State University Psychiatry Past Accepting new patients

Locations

804 Service Rd
#A201
East Lansing, MI 48824
Phone (517) 884-2976

909 Wilson Rd
Ste B119
East Lansing, MI 48824

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

909 Wilson Rd
Rm B119
East Lansing, MI 48824
Phone (517) 355-3070

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

1210 W Saginaw St
Lansing, MI 48915
Phone (517) 364-7180

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

1210 W Saginaw St
Fl 2
Lansing, MI 48915
Phone (517) 364-7575

Interoperability endpoints

  • Direct secure messaging: lionel.rosen.1@25394.direct.athenahealth.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.

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1689658056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD # A109B",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "517-884-2976",
            "fax_number": "517-432-3928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 FEE ROAD ROOM B119",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488243603",
            "telephone_number": "517-353-3070",
            "fax_number": "517-432-3603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "LIONEL",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301029268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689658056",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

Verify at the official NPI Registry.