Individual provider Active NPI

Alyssa Rose, AUD

  • Audiologist
  • Mt Pleasant, MI
National Provider Identifier
1144997354
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Practice address
1290 E Broomfield St
Mt Pleasant, MI 48858-4449
Phone
(989) 773-1209
Fax
(989) 773-4267
NPI assigned
Aug 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X Primary

Addresses

Primary practice location

1290 E Broomfield St
Mt Pleasant, MI 48858-4449

Mailing address

1290 E Broomfield St
Mt Pleasant, MI 48858-4449
Phone (989) 773-1209

Other practice location 1

1504 Harcrest Dr Ste 3
Midland, MI 48640-4717
Phone (989) 835-1219

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211019000824 MI Practitioner - Qualified Audiologist 0749678043 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Michigan Audiology LLCGroup PAC ID 7012009301, 2 clinicians

Practice addresses (Care Compare)

1504 Harcrest Dr
Suite 3
Midland, MI 48640-4717
Phone (989) 835-1219

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Central Michigan Audiology LLC Audiologist CurrentSince Aug 24, 2021 Accepting new patients

Locations

647 W Warwick Dr
Alma, MI 48801
Phone (989) 463-0951

4615 Eastman Ave
Midland, MI 48640
Phone (989) 631-7110

1504 Harcrest Dr
Ste 3
Midland, MI 48640
Phone (989) 636-7580

1290 E Broomfield St
Mt Pleasant, MI 48858
Phone (989) 341-4716

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": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1144997354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 E BROOMFIELD ST",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488584449",
            "telephone_number": "989-773-1209",
            "fax_number": "989-773-4267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 E BROOMFIELD ST",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488584449",
            "telephone_number": "989-773-1209",
            "fax_number": "989-773-4267"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1504 Harcrest Dr Ste 3",
            "address_purpose": "LOCATION",
            "city": "Midland",
            "state": "MI",
            "postal_code": "486404717",
            "country_code": "US",
            "telephone_number": "989-835-1219",
            "fax_number": "989-835-7198",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSE",
        "first_name": "ALYSSA",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-25",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.