Individual provider Active NPI

Amber Krusniak, DC

  • Chiropractor
  • Grand Rapids, MI
National Provider Identifier
1003620907
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301401609 Issued in MI
Practice address
5150 Northland Dr NE Ste B
Grand Rapids, MI 49525-1081
Phone
(616) 314-7616
NPI assigned
Feb 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301401609 MI Primary

Addresses

Primary practice location

5150 Northland Dr NE Ste B
Grand Rapids, MI 49525-1081

Mailing address

9664 Hayden Dr Apt 5
Mascoutah, IL 62258-5517

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250903000232 MI Practitioner - Chiropractic 5193226835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5150 Northland Dr NE
Suite B
Grand Rapids, MI 49525-1081

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Elevate Family Chiropractic LLC Chiropractor CurrentSince Jun 27, 2025 Accepting new patients

Locations

5150 Northland Dr NE
Ste B
Grand Rapids, MI 49525
Phone (616) 314-7616

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": "1738540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1003620907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9664 HAYDEN DR APT 5",
            "city": "MASCOUTAH",
            "state": "IL",
            "postal_code": "622585517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 NORTHLAND DR NE STE B",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495251081",
            "telephone_number": "616-314-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSNIAK",
        "first_name": "AMBER",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-03",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301401609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.