Individual provider Active NPI

Alyson Marie Lenz

  • Physician Assistant
  • Fenton, MI
National Provider Identifier
1376231142
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601012527 Issued in MI
Practice address
1451 N Leroy St
Fenton, MI 48430-2763
Phone
(810) 564-7995
NPI assigned
Apr 28, 2023
Last updated
Sep 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601012527 MI Primary

Addresses

Primary practice location

1451 N Leroy St
Fenton, MI 48430-2763

Mailing address

4090 Geddes Rd
Ann Arbor, MI 48105-2750
Phone (810) 564-7995

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250609003131 MI Practitioner - Physician Assistant 9436669421 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amd Urgent Medical Care, PLLCGroup PAC ID 6608021738, 5 clinicians
Amd Urgent Care FentonGroup PAC ID 1658752597, 3 clinicians

Practice addresses (Care Compare)

11307 N Linden Rd
Suite B
Clio, MI 48420-8589
Phone (810) 564-7995

1455 N Leroy St
Fenton, MI 48430-2763

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5601012527MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Amd Primary Care, PLLC PastSince Jul 21, 2015 Accepting new patients

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, 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": "1682640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1376231142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4090 GEDDES RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481052750",
            "telephone_number": "810-564-7995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 N LEROY ST",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484302763",
            "telephone_number": "810-564-7995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENZ",
        "first_name": "ALYSON",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-28",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601012527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MI

Sources for this page

Verify at the official NPI Registry.