Active NPI
Balsam Elajouz
- Pharmacist
- Grand Rapids, MI
National Provider Identifier
1477403582
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302413556
- Practice address
- 200 Jefferson Ave SE
Grand Rapids, MI 49503-4502 - Phone
- (616) 685-5000
- NPI assigned
- Jan 29, 2026
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302413556 | MI | Primary |
Addresses
Primary practice location
200 Jefferson Ave SE
Grand Rapids, MI 49503-4502
Mailing address
261 Netherfield St NW
Comstock Park, MI 49321-9343
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302413556 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1769644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769644800000",
"number": "1477403582",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "261 NETHERFIELD ST NW",
"city": "COMSTOCK PARK",
"state": "MI",
"postal_code": "493219343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 JEFFERSON AVE SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495034502",
"telephone_number": "616-685-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELAJOUZ",
"first_name": "BALSAM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-01-29",
"last_updated": "2026-01-29",
"certification_date": "2026-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302413556",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.