Jacquelyn Marie Charbel, DO
Individual provider Active NPI Colon & Rectal Surgery Physician · East Lansing, MI
NPI 1760623318 · NPPES record last updated Oct 22, 2024
Key facts
- NPI
- 1760623318
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Colon & Rectal Surgery Physician 208C00000X
- License
- 5101018375 (MI)
- Practice address
- 4660 S Hagadorn Rd Ste 600
East Lansing, MI 48823-5383 - Phone
- (517) 355-4205
- Fax
- (517) 355-4202
- NPI assigned
- Mar 11, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Colorectal Surgery (Proctology)
- Education
- Lake Erie College of Osteopathic Medicine, Erie, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- McLaren Greater Lansing
Msu Health Care Inc.
Practice addresses (Care Compare)
2900 Collins Rd
Lansing, MI 48910-8394
Phone (517) 975-7575
3220 Discovery Dr
Suite 200
Lansing, MI 48910-8556
Phone (517) 975-8910
3520 Forest Rd
FL 3
Lansing, MI 48910-3720
Phone (517) 975-6425
4660 S Hagadorn Rd
East Lansing, MI 48823-5353
4660 S Hagadorn Rd
Suite 500
East Lansing, MI 48823-6804
Phone (517) 884-4554
Hospital & facility affiliations
- McLaren Greater Lansing
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 24 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150730012423 | MI | Practitioner - Colorectal Surgery (Proctology) | 2961634365 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101018375 | MI | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Msu Health Care Inc. | Current |
Accepting new patients | |
| Msu Health Care Inc | Current | Accepting new patients | |
| Msu Health Care Inc. | Current |
Accepting new patients | |
| Covenant Medical Center, Inc | Current |
Accepting new patients | |
| Covenant Medical Center, Inc. | Current | Accepting new patients | |
| Satnam Medical PLLC | Past | Accepting new patients | |
| Msu Health Care Inc. | Past | Accepting new patients |
Locations
1910 Pine Ave
Alma, MI 48801
Phone (989) 463-3101
4660 S Hagadorn Rd
Ste 600
East Lansing, MI 48823
Phone (517) 267-2460
4660 S Hagadorn Rd
Ste 500
East Lansing, MI 48823
Phone (517) 432-6144
4650 S Hagadorn Rd
Ste 100
East Lansing, MI 48823
Phone (517) 353-4830
804 Service Rd
Ste A109B
East Lansing, MI 48824
Phone (517) 884-2976
804 Service Rd
Ste A202
East Lansing, MI 48824
Phone (517) 884-2976
4660 S Hagadorn Rd
Ste 210
East Lansing, MI 48823
Phone (517) 353-3102
1447 N Harrison St
Saginaw, MI 48602
Phone (989) 583-4220
900 Cooper Ave
Ste 4300
Saginaw, MI 48602
Phone (989) 583-7460
Interoperability endpoints
- jacquelyn.charbel.1@25394.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 5101018375 | MI | |
| Colon & Rectal Surgery Physician | 208C00000X | 5101018375 | MI | Yes |
Addresses
Primary practice location
4660 S Hagadorn Rd Ste 600
East Lansing, MI 48823-5383
Mailing address
804 Service Rd Ste A202
East Lansing, MI 48824-7015
Phone (517) 355-4205
Other practice location 1
4660 S Hagadorn Rd Ste 210
East Lansing, MI 48823-5353
Phone (517) 353-3102
Other practice location 2
3250 Forest Rd
Lansing, MI 48910-3720
Phone (517) 975-6000
Other providers in East Lansing, MI
- Gina Chacon Osorio
- Ruby Chahal
- Amelia Chandler
- Ekta Chandwani
- Change4Greatness LLC
- Larry Charleston IV
- Haileyann Marie Charrier
- Adam Chartrand
- Bianca Chavez
- Huiting Chen
All providers in East Lansing, MI · Colon & Rectal Surgery Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.