Active NPI
Alycia Rae Dzierwa, FNP-C
- Family Nurse Practitioner
- Traverse City, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4704369243
- Practice address
- 1105 Sixth St
Traverse City, MI 49684-2386 - Phone
- (231) 935-5000
- NPI assigned
- Jul 24, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704369243 | MI | Primary |
Addresses
Primary practice location
1105 Sixth St
Traverse City, MI 49684-2386
Mailing address
9775 E Jennings Dr
Traverse City, MI 49684-2721
Phone (231) 357-6385
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Saginaw Valley Medical College - NLG, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10223 E Cherry Bend Rd
Cherry Bend Family Care
Traverse City, MI 49684-7304
Phone (231) 929-7933
1105 6TH St
Traverse City, MI 49684-2345
Phone (231) 935-5000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sound Inpatient Physicians-Michigan, PLLC | Current | Accepting new patients | |
| Cherry Bend Family Care, PLC | Current | Accepting new patients | |
| Grand Traverse Physician Services PC | Current | Accepting new patients | |
| Sound Inpatient Physicians - Michigan, PLLC | Current | Accepting new patients |
Locations
400 Hobart St
Cadillac, MI 49601
Phone (231) 876-7200
580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131
10223 E Cherry Bend Rd
Traverse City, MI 49684
Phone (231) 929-7933
1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000
120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/JDAHAA
Organizations & group practices 5
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.
-
- Family Medicine Physician
- Traverse City, MI
- NPI 1801811369
-
- Hospitalist Physician
- Traverse City, MI
- NPI 1932913217
-
- Internal Medicine Physician
- Kalamazoo, MI
- NPI 1093967861
-
- Hospitalist Physician
- Cadillac, MI
- NPI 1649084260
-
- Hospitalist Physician
- Escanaba, MI
- NPI 1366768178
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Traverse City, MI
- NPI 1952307852
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726531200000",
"number": "1184452815",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9775 E JENNINGS DR",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496842721",
"telephone_number": "231-357-6385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1105 SIXTH ST",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496842386",
"telephone_number": "231-935-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DZIERWA",
"first_name": "ALYCIA",
"middle_name": "RAE",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-24",
"last_updated": "2024-09-17",
"certification_date": "2024-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704369243",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; 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.
- 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.