Individual provider Active NPI

Lena Widman, DO

  • Family Medicine Physician
  • Mount Pleasant, MI
National Provider Identifier
1730560970
Registry record updated Jan 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101021632 Issued in MI
Practice address
4851 E Pickard St
Mount Pleasant, MI 48858
Phone
(989) 775-1610
Fax
(989) 775-1640
NPI assigned
Jun 13, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101021632 MI Primary

Addresses

Primary practice location

4851 E Pickard St
Mount Pleasant, MI 48858

Mailing address

4851 E Pickard St
Mount Pleasant, MI 48858-2029
Phone (989) 775-1610

Other practice location 1

550 Munson Ave
Traverse City, MI 49686
Phone (231) 935-8686

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
I20170329002701 MI Practitioner - Family Practice 6103101316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mymichigan Medical Center AlmaGroup PAC ID 3375451404, 140 clinicians

Practice addresses (Care Compare)

4851 E Pickard St
Mt Pleasant, MI 48858-2029
Phone (989) 775-1610

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Alma Family Medicine CurrentSince Nov 19, 2018 Accepting new patients
Mymichigan Medical Center Alma Current Accepting new patients
Mymichigan Medical Center Alma Past Accepting new patients

Locations

300 E Warwick Dr
Alma, MI 48801
Phone (989) 463-0104

321 E Warwick Dr
Alma, MI 48801
Phone (989) 463-0957

602 Beech St
Ste 1100
Clare, MI 48617
Phone (989) 386-9911

121 N Pine River St
Ithaca, MI 48847
Phone (989) 875-0662

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

4851 E Pickard St
Mt Pleasant, MI 48858
Phone (989) 772-3009

4851 E Pickard St
Ste 1760
Mt Pleasant, MI 48858
Phone (989) 775-1610

Interoperability endpoints

  • Direct secure messaging: lwidman77769@mymichiganhealth.midirect.net

Organizations & group practices 3

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 5

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": "1434153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547078400000",
    "number": "1730560970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4851 E PICKARD ST",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488582029",
            "telephone_number": "989-775-1610",
            "fax_number": "989-775-1640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4851 E PICKARD ST",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "48858",
            "telephone_number": "989-775-1610",
            "fax_number": "989-775-1640"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 Munson Ave",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "49686",
            "country_code": "US",
            "telephone_number": "231-935-8686",
            "fax_number": "231-935-8708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIDMAN",
        "first_name": "LENA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-13",
        "last_updated": "2019-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101021632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, MI

Sources for this page

Verify at the official NPI Registry.