Individual provider Active NPI

Alyssa Renee Hartley, FNP-C

  • Family Nurse Practitioner
  • Hillsdale, MI
National Provider Identifier
1508455916
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704299192 Issued in MI
Practice address
61 W Carleton Rd
Hillsdale, MI 49242-1201
Phone
(517) 439-5411
NPI assigned
Jan 12, 2021
Last updated
Jan 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704299192 MI Primary

Addresses

Primary practice location

61 W Carleton Rd
Hillsdale, MI 49242-1201

Mailing address

16901 Medina Road
Hudson, MI 49247
Phone (517) 398-3095

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
I20210419001408 MI Practitioner - Nurse Practitioner 5799193496 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

61 W Carleton Rd
Hillsdale, MI 49242-1201
Phone (517) 439-5411

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hillsdale Community Health Center CurrentSince Jan 16, 2021 Accepting new patients
Hillsdale Community Health Center Past Accepting new patients

Locations

1456 Hudson Rd
Hillsdale, MI 49242
Phone (517) 439-0200

168 S Howell St
Hillsdale, MI 49242
Phone (517) 437-4451

168 S Howell St
Fl 3
Hillsdale, MI 49242

240 W Carleton Rd
Hillsdale, MI 49242
Phone (517) 437-7040

451 Hidden Meadows Dr
Ste 220
Hillsdale, MI 49242
Phone (517) 437-5395

61 W Carleton Rd
Hillsdale, MI 49242
Phone (517) 437-5020

Organizations & group practices 3

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 1

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": "1610409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1508455916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16901 MEDINA ROAD",
            "city": "HUDSON",
            "state": "MI",
            "postal_code": "49247",
            "telephone_number": "517-398-3095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 W CARLETON RD",
            "city": "HILLSDALE",
            "state": "MI",
            "postal_code": "492421201",
            "telephone_number": "517-439-5411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTLEY",
        "first_name": "ALYSSA",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-12",
        "last_updated": "2021-01-12",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704299192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsdale, MI

Sources for this page

Verify at the official NPI Registry.