Individual provider Active NPI

Elise Patricia Krzesimowski, AU.D.

  • Audiologist
  • Clinton Township, MI
National Provider Identifier
1114571460
Registry record updated Mar 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
1601000839 Issued in MI
Practice address
36539 Harper Ave
Clinton Township, MI 48035-2012
Phone
(586) 900-8225
Fax
(920) 356-6419
NPI assigned
Jul 25, 2019
Last updated
Mar 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 1601000839 MI Primary

Addresses

Primary practice location

36539 Harper Ave
Clinton Township, MI 48035-2012

Mailing address

120 Park Ave Ste 1
Beaver Dam, WI 53916-2132
Phone (920) 885-5225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190827003480 MI Practitioner - Qualified Audiologist 2163750225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Repose PLLCGroup PAC ID 2769854579, 3 clinicians

Practice addresses (Care Compare)

36557 Harper Ave
Clinton TWP, MI 48035-2012
Phone (586) 228-0600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1601000839MIMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Repose PLLC CurrentSince Jan 2, 2023 Accepting new patients
Harper Metro CT Partnership PastSince Jan 2, 2023 Accepting new patients

Locations

36539 Harper Ave
Clinton Twp, MI 48035
Phone (586) 792-8877

36557 Harper Ave
Clinton Twp, MI 48035
Phone (586) 228-0600

120 Park Ave
Ste 1
Beaver Dam, WI 53916
Phone (920) 356-6416

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772928000000",
    "number": "1114571460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 PARK AVE STE 1",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539162132",
            "telephone_number": "920-885-5225",
            "fax_number": "920-356-6419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36539 HARPER AVE",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480352012",
            "telephone_number": "586-900-8225",
            "fax_number": "920-356-6419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRZESIMOWSKI",
        "first_name": "ELISE",
        "middle_name": "PATRICIA",
        "name_prefix": "Mrs.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-25",
        "last_updated": "2026-03-08",
        "certification_date": "2026-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MI",
            "license": "1601000839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2026; 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.