Alexander Mervenne, CAA

Primary specialty

Anesthesiologist AssistantTaxonomy code 367H00000X

License

789789817 Issued in MI

Practice address

100 Michigan St NE
Grand Rapids, MI 49503-2560

Phone

(616) 364-4200

Fax

(616) 364-7347

NPI assigned

May 22, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, IN2 enrollments

Enrollment records 2

Specialty

Anesthesiology Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Porter County Anesthesia Associates PCGroup PAC ID 4789573411, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwest Health - Porter Hospital, Valparaiso, IN, CCN 150035

Medicare enrollment (NPD)

Enrolled

Credentials

Associate of Arts

State licenses

Practice roles

Locations

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.

• Porter County Anesthesia Associates PC

  • Anesthesiology Physician
  • Valparaiso, IN
  • NPI 1215974936
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Porter Hospital LLC

  • General Acute Care Hospital
  • Valparaiso, IN
  • NPI 1215151154
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1497447262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259493",
            "telephone_number": "616-364-4200",
            "fax_number": "616-364-7347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-364-4200",
            "fax_number": "616-364-7347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERVENNE",
        "first_name": "ALEXANDER",
        "credential": "CAA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "MI",
            "license": "789789817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryce Allen Merritt, MD
• Timothy Devon Merriweather
• Emily Whetter Mersman, PA
• Courtney Mertel
• Deborah Marie Mervau Scheidel, OTR
• Gregory S Mervenne, MD
• Lisa Ann Mervenne, O.T.R.
• Gagindip Merwar, MD
• Daniel Allen Mesaros, CAA
• Shelby Taylor Meshinski, MD

• Anesthesiologist Assistant in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Anesthesiologist Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.