NPIMap

Individual provider Active NPI

Christine Amber Elsholz, MD

  • Family Medicine Physician
  • Bridgeport, MI
National Provider Identifier
1073595674
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301063548 Issued in MI
Practice address
6297 Dixie Highway
Bridgeport, MI 48722-9635
Phone
(989) 759-6460
Fax
(989) 759-6465
NPI assigned
Nov 18, 2005
Last updated
Apr 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301063548 MI Primary

Addresses

Primary practice location

6297 Dixie Highway
Bridgeport, MI 48722-9635

Mailing address

501 Lapeer Ave
Saginaw, MI 48607-1208
Phone (989) 759-6464

Other identifiers 12

IdentifierTypeStateIssuer
4761998MedicaidMI
1073595674MedicaidMI
150960OtherGREAT LAKES HEALTH PLAN
321OtherMICARE SOURCE OF MICHIGAN
1017365OtherMIMCLAREN HEALTH PLAN OF MI
P00380702OtherMIRAILROAD MEDICARE
080G310660OtherMIBLUE CROSS BLUE SHIELD OF MICHIGAN
0980802OtherMIHEALTHPLUS OF MICHIGAN
381908328OtherPPOM
4671988OtherMOLINA HEALTH CARE OF MI
7606126OtherMIAETNA
381908328OtherHCAP

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address christine.elsholz@direct.medfusion.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040202000768 MI Practitioner - Family Practice 5799688057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Human Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Lakes Bay Health CentersGroup PAC ID 2466369046, 85 clinicians

Practice addresses (Care Compare)

6297 Dixie Hwy
Bridgeport, MI 48722-9635
Phone (989) 759-6460

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Genesys Hospital Past Accepting new patients
Genesys Integrated Group Practice PC Past Accepting new patients
Great Lakes Bay Health Centers Family Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: christine.elsholz.1@27771.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/8209/brand/5/csg/21/fhir/r4

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1073595674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 LAPEER AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486071208",
            "telephone_number": "989-759-6464",
            "fax_number": "989-399-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6297 DIXIE HIGHWAY",
            "city": "BRIDGEPORT",
            "state": "MI",
            "postal_code": "487229635",
            "telephone_number": "989-759-6460",
            "fax_number": "989-759-6465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELSHOLZ",
        "first_name": "CHRISTINE",
        "middle_name": "AMBER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-18",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301063548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4761998",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073595674",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT LAKES HEALTH PLAN",
            "identifier": "150960",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE SOURCE OF MICHIGAN",
            "identifier": "321",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN HEALTH PLAN OF MI",
            "identifier": "1017365",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00380702",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MICHIGAN",
            "identifier": "080G310660",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPLUS OF MICHIGAN",
            "identifier": "0980802",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPOM",
            "identifier": "381908328",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA HEALTH CARE OF MI",
            "identifier": "4671988",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7606126",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HCAP",
            "identifier": "381908328",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "christine.elsholz@direct.medfusion.com",
            "affiliation": "N",
            "address_1": "6297 Dixie Highway",
            "city": "Bridgeport",
            "state": "MI",
            "country_code": "US",
            "postal_code": "487229635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bridgeport, MI

Sources for this page

Verify at the official NPI Registry.