Individual provider Active NPI

Kenneth Elmassian, DO

  • Anesthesiology Physician
  • Lansing, MI
National Provider Identifier
1780656561
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
KE007148 Issued in MI
Practice address
2900 Collins Rd # 106
Lansing, MI 48910-8394
Phone
(517) 482-2118
Fax
(517) 482-6280
NPI assigned
Feb 6, 2006
Last updated
Feb 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X KE007148 MI Primary

Addresses

Primary practice location

2900 Collins Rd # 106
Lansing, MI 48910-8394

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1320111MedicaidMI

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
I20080820000318 MI Practitioner - AnesthesiologyPractitioner - Pain Management 1658446075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Michigan State University College of Osteopathic Medicine, 1976
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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
KE007148MIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Area Anesthesia PC CurrentSince Nov 15, 1976 Accepting new patients
B & C Anesthesia Services LLC Past Accepting new patients

Locations

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

2900 Collins Rd
#106
Lansing, MI 48910
Phone (517) 482-2118

405 W Greenlawn Ave
Ste 106
Lansing, MI 48910
Phone (517) 482-2118

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

Organizations & group practices 2

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.

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": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1780656561",
    "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",
            "fax_number": "517-482-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 COLLINS RD # 106",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489108394",
            "telephone_number": "517-482-2118",
            "fax_number": "517-482-6280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELMASSIAN",
        "first_name": "KENNETH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "KE007148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1320111",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.