SMG Bariatric Surgery – Obesity Medicine (Internal Medicine) Physician, NPI 1083982748

SMG Bariatric Surgery is a healthcare provider. based in East lansing, Michigan. specializing in Obesity Medicine (Internal Medicine) Physician. The NPI Number for SMG Bariatric Surgery is 1083982748

Main info

Organization
Name
SMG Bariatric Surgery
NPI
1083982748
Phone
(517) 364-8080
Address
2900 HANNAH BLVD
Authorized Official
MISTY GUNTER RUSSIAN SUPERVISOR, PROVIDER ENROLLMENT
Enumeration Date
9 December 2011
Last Update Date
27 March 2024
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness80
Years active:14State licenses:0Digital endpointsUpdated within 12 months

Provider Addresses for SMG Bariatric Surgery

  • 2900 HANNAH BLVD

    SUITE 216

    EAST LANSING, MI 488235384

    Phone: (517) 364-8080

    Type: Mailing

  • 8175 RELIABLE PKWY

    CHICAGO, IL 606860081

    Phone: (517) 364-8080

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20050210000079OClinic/Group PracticeMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48823)

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Reviews

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Frequently asked questions

What number should I use to identify SMG Bariatric Surgery for billing?
Administrative and clinical systems typically use NPI 1083982748 for SMG Bariatric Surgery.
Should I treat SMG Bariatric Surgery as an active provider?
Patients and plans typically see SMG Bariatric Surgery as active in the national extract.
What services align with SMG Bariatric Surgery's listing?
SMG Bariatric Surgery's public classification highlights Obesity Medicine (Internal Medicine) Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to SMG Bariatric Surgery?
SMG Bariatric Surgery is associated with East Lansing, Michigan in the same public data insurers reference.
Can I export SMG Bariatric Surgery's record?
You can download the official NPPES record; we summarize key fields for readability.

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