Alexandria Mendola, AGACNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704306796 Issued in MI

Practice address

25195 Kelly Rd Ste a
Roseville, MI 48066-5084

Phone

(586) 775-4594

NPI assigned

Jun 9, 2019

Sex

Female

Sole proprietor

No

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

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

Specialty

Nurse Practitioner

Education

University of Michigan Medical School, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Health St. John HospitalGroup PAC ID 3173424082, 332 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: apawlusiak36364@direct.trinity-health.org
• Direct secure messaging: alexandria.pawlusiak.1@8209.direct.athenahealth.com

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.

• Henry Ford Health St. John Hospital

  • Podiatrist
  • Harrison Township, MI
  • NPI 1043478910
  Medicare reassignment Care Compare group NPD
• Michigan Kidney Consultants, P.C.

  • Nephrology Physician
  • Sterling Heights, MI
  • NPI 1831130723
  Medicare reassignment NPD
• Henry Ford Health St. John Hospital

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1912965088
  NPD
• Henry Ford Health St. John Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1023088168
  NPD

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

• Henry Ford Health St. John Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1023088168
  Care Compare affiliation

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

{
    "created_epoch": "1560038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1598324048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22819 SUNNYSIDE ST",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802463",
            "telephone_number": "586-413-0169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25195 KELLY RD STE A",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480665084",
            "telephone_number": "586-775-4594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOLA",
        "first_name": "ALEXANDRIA",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-09",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704306796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyra Lajoy McKinley, LPN
• Emily S McManaman, M.A, BCBA, LBA
• Haresh S Mehta, M.D.
• Meijer Inc
• Denurah Menanndruzz
• Mental Wellness Group LLC
• Francine Mercene, PHARMD
• Mercy Medical Pharmacy , LLC
• Mercy Transport LLC
• Marya Meroueh

• Nurse Practitioner in Roseville, MI
• Providers in Roseville, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.