Individual provider Active NPI

Michelle Renee Gronowski, FNP-C

  • Adult Health Nurse Practitioner
  • Troy, MI
National Provider Identifier
1639816549
Registry record updated May 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F12200265 Issued in MI
Practice address
1977 W Maple Rd
Troy, MI 48084-7109
Phone
(248) 722-9323
NPI assigned
May 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F12200265 MI Primary

Addresses

Primary practice location

1977 W Maple Rd
Troy, MI 48084-7109

Mailing address

3160 Baldwin Square Rd
Lake Orion, MI 48359-2161
Phone (248) 762-8610

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
I20230727002308 MI Practitioner - Nurse Practitioner 1355702051 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F12200265MIMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Infectious Disease Consultants LLC CurrentSince Jul 1, 2023 Accepting new patients
Metro Infectious Disease Consultants, LLC CurrentSince Jul 1, 2023 Accepting new patients

Locations

901 McClintock Dr
Ste 202
Burr Ridge, IL 60527
Phone (630) 654-4201

3055 Plymouth Rd
Ste 103
Ann Arbor, MI 48105

15474 N Haggerty Rd
Plymouth, MI 48170
Phone (734) 335-6103

1231 Pine Grove Ave
Ste 1B
Port Huron, MI 48060
Phone (810) 984-8650

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1652400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1639816549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3160 BALDWIN SQUARE RD",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483592161",
            "telephone_number": "248-762-8610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1977 W MAPLE RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480847109",
            "telephone_number": "248-722-9323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRONOWSKI",
        "first_name": "MICHELLE",
        "middle_name": "RENEE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-13",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "F12200265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.