Individual provider Active NPI

Jennifer Uitvlugt, D.O.

  • Trauma Surgery Physician
  • East Lansing, MI
National Provider Identifier
1841554581
Registry record updated Sep 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
5101019957 Issued in MI
Practice address
4660 S Hagadorn Rd Ste 600
East Lansing, MI 48823-5383
Phone
(517) 267-2460
Fax
(517) 267-2462
NPI assigned
Jun 27, 2012
Last updated
Sep 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 5101019957 MI
Trauma Surgery Physician 2086S0127X 5101019957 MI Primary

Addresses

Primary practice location

4660 S Hagadorn Rd Ste 600
East Lansing, MI 48823-5383

Mailing address

804 Service Rd Ste A109B
East Lansing, MI 48824-7015
Phone (517) 267-2460

Other practice location 1

1215 E Michigan Ave
Lansing, MI 48912-1811
Phone (517) 364-2616

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
I20191003002873 MI Practitioner - General Surgery 5698085884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of New England, College of Osteo Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1215 E Michigan Ave
Lansing, MI 48912-1811

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101019957MIMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward W. Sparrow Hospital Association Surgery CurrentSince Mar 1, 2021 Accepting new patients
Edward W Sparrow Hospital Association CurrentSince Mar 1, 2021 Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients
Edward W Sparrow Hospital Association Past Accepting new patients
Msu Health Care Inc. Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

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

4660 S Hagadorn Rd
Ste 600
East Lansing, MI 48823
Phone (517) 267-2460

1200 E Michigan Ave
Ste 510
Lansing, MI 48912
Phone (517) 364-5184

1200 E Michigan Ave
Ste 655
Lansing, MI 48912
Phone (517) 267-2460

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

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

Organizations & group practices 5

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 2

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": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1841554581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD STE A109B",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "517-267-2460",
            "fax_number": "517-267-2462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 S HAGADORN RD STE 600",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488235383",
            "telephone_number": "517-267-2460",
            "fax_number": "517-267-2462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 E Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489121811",
            "country_code": "US",
            "telephone_number": "517-364-2616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UITVLUGT",
        "first_name": "JENNIFER",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-27",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101019957",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "MI",
            "license": "5101019957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

Verify at the official NPI Registry.