Active NPI
Lance Furusawa-Stratton, MD
- Diagnostic Radiology Physician
- Grand Rapids, MI
National Provider Identifier
1871868679
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 4301502854
- Practice address
- 3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746 - Phone
- (616) 363-7272
- Fax
- (616) 361-5828
- NPI assigned
- Mar 13, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 2017-00531 | NC | |
| Diagnostic Radiology Physician | 2085R0202X | MD-18995 | HI | |
| Diagnostic Radiology Physician | 2085R0202X | 4301502854 | MI | Primary |
Addresses
Primary practice location
3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Mailing address
3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Phone (616) 363-7272
Other practice location 1
622 W 168th St
New York, NY 10032-3720
Phone (212) 305-2500
Other practice location 2
1331 N Elm St Ste 200
Greensboro, NC 27401
Phone (336) 274-9617
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871868679 | Medicaid | NC |
Other names 1
- Lance Stratton
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in HI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599004800000",
"number": "1871868679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3264 N EVERGREEN DR NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495259746",
"telephone_number": "616-363-7272",
"fax_number": "616-361-5828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3264 N EVERGREEN DR NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495259746",
"telephone_number": "616-363-7272",
"fax_number": "616-361-5828"
}
],
"practiceLocations": [
{
"address_1": "622 W 168th St",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100323720",
"country_code": "US",
"telephone_number": "212-305-2500",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1331 N Elm St Ste 200",
"address_purpose": "LOCATION",
"city": "Greensboro",
"state": "NC",
"postal_code": "27401",
"country_code": "US",
"telephone_number": "336-274-9617",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FURUSAWA-STRATTON",
"first_name": "LANCE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-03-13",
"last_updated": "2020-09-02",
"certification_date": "2020-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NC",
"license": "2017-00531",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "HI",
"license": "MD-18995",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MI",
"license": "4301502854",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1871868679",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LANCE",
"last_name": "STRATTON",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.