Individual provider Active NPI

Yuriy Bukavyn, M.D.

  • Family Medicine Physician
  • East Lansing, MI
National Provider Identifier
1972815272
Registry record updated Mar 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301102164 Issued in MI
Practice address
2682 E Grand River Ave
East Lansing, MI 48823-5608
Phone
(517) 333-6562
Fax
(517) 333-6563
NPI assigned
Jul 2, 2010
Last updated
Mar 27, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2015

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 4301102164 MI Primary

Addresses

Primary practice location

2682 E Grand River Ave
East Lansing, MI 48823-5608

Mailing address

PO Box 13008
Lansing, MI 48901-3008
Phone (517) 333-6562

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
I20131226000219 MI Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 5395972129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

800 E Columbia St
Sparrow Family Medicine Residency
Mason, MI 48854-1381
Phone (517) 244-8940

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Physician Assistant

State licenses

LicenseStateTypeSpecialty
4301102164MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward W. Sparrow Hospital Association CurrentSince Aug 17, 2018 Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients
Edward W. Sparrow Hospital Association Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

2682 E Grand River Ave
East Lansing, MI 48823
Phone (517) 333-6352

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

716 N Clippert St
Lansing, MI 48912
Phone (517) 253-4000

800 E Columbia St
Mason, MI 48854
Phone (517) 244-8900

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, 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": "1278028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427414400000",
    "number": "1972815272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13008",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489013008",
            "telephone_number": "517-333-6562",
            "fax_number": "517-333-6563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2682 E GRAND RIVER AVE",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488235608",
            "telephone_number": "517-333-6562",
            "fax_number": "517-333-6563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUKAVYN",
        "first_name": "YURIY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-02",
        "last_updated": "2015-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301102164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

Verify at the official NPI Registry.