Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Micah Lissy, MD

Individual provider Sports Medicine (Orthopaedic Surgery) Physician · NPI 1154627370

Micah Lissy, MD is an Orthopedic Surgery in East Lansing, Michigan. Qualified in 2007, 19 years ago. Practices with Msu Health Care Inc, a 201-clinician group and accepts Medicare assignment. Licensed in Michigan and New York.

Years since qualifying
19
Licensed in
MI, NY
In the registry since
2011
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4660 S Hagadorn Rd Ste 420
East Lansing, MI 48823-5353
Phone: (517) 884-6100
Fax: (517) 884-6233
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Orthopaedic Surgery) Physician (primary) Taxonomy 207XX0005X · Licence 4301099989 (MI)
Sports Medicine (Orthopaedic Surgery) Physician Taxonomy 207XX0005X · Licence 261158 (NY)

Record details

NPI number1154627370
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedFebruary 4, 2011
Last updated in NPPESJuly 26, 2022
Certification dateJuly 26, 2022
Mailing address804 Service Rd Ste A109b, East Lansing, MI 48824-7015

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyORTHOPEDIC SURGERY
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Msu Health Care Inc. — 201 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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