Individual provider Active NPI

Alyssa Marie Adams, RN

  • Registered Nurse
  • Chesterfield, MI
National Provider Identifier
1386357135
Registry record updated Dec 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
21256071427 Issued in MI
Practice address
29284 Classic Dr
Chesterfield, MI 48051-3787
Phone
(586) 747-1384
NPI assigned
Dec 26, 2022
Last updated
Dec 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 21256071427 MI Primary

Addresses

Primary practice location

29284 Classic Dr
Chesterfield, MI 48051-3787

Mailing address

29284 Classic Dr
Chesterfield, MI 48051-3787
Phone (586) 747-1384

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241001004158 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 5294266201 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastside Group LLCGroup PAC ID 4486790219, 36 clinicians
Northstar Anesthesia of Michigan PLLCGroup PAC ID 9638481591, 192 clinicians

Practice addresses (Care Compare)

28963 Little Mack Ave
Suite 103
Saint Clair Shores, MI 48081-3017
Phone (586) 447-5110

3990 John R St
Detroit, MI 48201-2018
Phone (313) 993-0822

4201 Saint Antoine St
Detroit, MI 48201-2153
Phone (313) 745-3615

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
21256071427MIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Michigan PLLC CurrentSince Sep 1, 2024 Accepting new patients

Locations

4100 John R St
#A
Detroit, MI 48201

4201 Saint Antoine St
Detroit, MI 48201
Phone (313) 745-3615

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 3

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": "1672012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672012800000",
    "number": "1386357135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29284 CLASSIC DR",
            "city": "CHESTERFIELD",
            "state": "MI",
            "postal_code": "480513787",
            "telephone_number": "586-747-1384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29284 CLASSIC DR",
            "city": "CHESTERFIELD",
            "state": "MI",
            "postal_code": "480513787",
            "telephone_number": "586-747-1384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "ALYSSA",
        "middle_name": "MARIE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-26",
        "last_updated": "2022-12-26",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "21256071427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2022; 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.