Alissa Enzenberger, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301500484 Issued in MI

Practice address

877 Forest Hill Ave SE
Grand Rapids, MI 49546-2380

Phone

(616) 402-2618

NPI assigned

Apr 1, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Forest Hills Pediatric Associates, PC

  • Pediatrics Physician
  • Grand Rapids, MI
  • NPI 1699767343
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1023471422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "877 FOREST HILL AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462380",
            "telephone_number": "616-949-4465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 FOREST HILL AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462380",
            "telephone_number": "616-402-2618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENZENBERGER",
        "first_name": "ALISSA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-01",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301500484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Enriquez, LLMSW
• Jeffrey Ensing, PHARMD
• Sophia Ensing
• Elliot Michael Ensink, DO/PHD
• ENT Consultants PLC
• Epic Discoveries LLC
• Richard Grant Erard, P.A.-C
• Uma E Erard, DO
• Brant A Erbentraut, D.D.S.
• Daniel Kristoffer Erck, D.O.

• Pediatrics Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; 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.

Verify at the official NPI Registry.