Individual provider Active NPI

Jacquelyn Dorenkamp, D.O.

  • Anesthesiology Physician
  • Lansing, MI
National Provider Identifier
1700267945
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
23114140432 Issued in MI
Practice address
2900 Collins Rd
Lansing, MI 48910-8394
Phone
(517) 975-6000
NPI assigned
Jun 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 23114140432 MI Primary
Anesthesiology Physician 207L00000X 0064153 CO

Addresses

Primary practice location

2900 Collins Rd
Lansing, MI 48910-8394

Mailing address

1749 Hamilton Rd Ste 102E
Okemos, MI 48864-1941
Phone (517) 482-2118

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
I20200207002487 MI Practitioner - Anesthesiology 6507292661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Michigan State University College of Osteopathic Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Area Anesthesia PCGroup PAC ID 8628975968, 33 clinicians

Practice addresses (Care Compare)

2900 Collins Rd
Lansing, MI 48910-8394
Phone (517) 975-6000

Hospital & facility affiliations

  • McLaren Greater Lansing Hospital, Lansing, MI, CCN 230167

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0064153COMDAnesthesiology Physician
23114140432MIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Area Anesthesia PC CurrentSince Jan 1, 2020 Accepting new patients

Locations

2900 Collins Rd
Lansing, MI 48910
Phone (517) 975-7500

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

1749 Hamilton Rd
Ste 102E
Okemos, MI 48864
Phone (517) 482-2118

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 1

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": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1700267945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1749 HAMILTON RD STE 102E",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488641941",
            "telephone_number": "517-482-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 COLLINS RD",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489108394",
            "telephone_number": "517-975-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORENKAMP",
        "first_name": "JACQUELYN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-12",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "23114140432",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CO",
            "license": "0064153",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.