Eleanor Dionise
Individual provider Active NPI Physician Assistant · Grand Ledge, MI
NPI 1073246732 · NPPES record last updated Oct 26, 2022
Key facts
- NPI
- 1073246732
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 5601011313 (MI)
- Practice address
- 1035 Charlevoix Dr Ste 100
Grand Ledge, MI 48837-2223 - Phone
- (517) 627-2181
- NPI assigned
- Jul 8, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230123000581 | MI | Practitioner - Physician Assistant | 3375914757 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601011313 | MI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Joshua P June DO | Current |
Accepting new patients | |
| Beals Institute PC | Past |
Accepting new patients |
Locations
4052 Legacy Pkwy
Ste 200
Lansing, MI 48911
Phone (517) 272-9700
Interoperability endpoints
- eleanor.dionise.p1@direct.glcor.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601011313 | MI | Yes |
Addresses
Primary practice location
1035 Charlevoix Dr Ste 100
Grand Ledge, MI 48837-2223
Mailing address
1035 Charlevoix Dr Ste 100
Grand Ledge, MI 48837-2223
Phone (517) 627-2181
Other providers in Grand Ledge, MI
- David J Harkema DMD
- David J. Smith MD PC
- Taylor Deacon
- Jami M Devarona
- Mary Elizabeth Dion
- Divine Mind Consultation Services
- Cassandra Dowker
- E & a Williams Corporation
- Nicole East
- Edward D. Ball D.O., P.C.
All providers in Grand Ledge, MI · Physician Assistant in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 26, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.