Individual provider Active NPI

Alyssa Jaworski, FNP-BC

  • Nurse Practitioner
  • Shelby Township, MI
National Provider Identifier
1649973538
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704354057 Issued in MI
Practice address
50505 Schoenherr Rd Ste 270
Shelby Township, MI 48315-3141
Phone
(586) 323-6058
Fax
(586) 500-8865
NPI assigned
Mar 22, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Wound Care Registered Nurse 163WW0000X 4704354057 MI
Nurse Practitioner 363L00000X 4704354057 MI Primary

Addresses

Primary practice location

50505 Schoenherr Rd Ste 270
Shelby Township, MI 48315-3141

Mailing address

50505 Schoenherr Rd Ste 270
Shelby Township, MI 48315-3141
Phone (586) 323-6058

Other practice location 1

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-8520

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
I20230928003532 MI Practitioner - Nurse Practitioner 6406200187 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Lakes Medicine PLCGroup PAC ID 4880613637, 33 clinicians
Premier Wound Care PLLCGroup PAC ID 6103273719, 13 clinicians

Practice addresses (Care Compare)

50505 Schoenherr Rd
Suite 340
Shelby Township, MI 48315-3140
Phone (586) 731-8400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704354057MIMDFamily Nurse Practitioner
4704354057NSA2307TMIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Medicine, PLC CurrentSince Oct 1, 2023 Accepting new patients
Vpa PC CurrentSince Jul 1, 2024 Accepting new patients
Premier Wound Care PLLC CurrentSince Aug 1, 2025 Accepting new patients
Vpa PC CurrentSince Jul 1, 2024 Accepting new patients

Locations

1746 Momentum Pl
Chicago, IL 60689

2205 Jolly Rd
Ste B
Okemos, MI 48864
Phone (517) 347-4085

50505 Schoenherr Rd
Ste 340
Shelby Township, MI 48315
Phone (586) 731-8400

500 Kirts Blvd
Ste 100
Troy, MI 48084
Phone (214) 824-6000

500 Kirts Blvd
Ste 200
Troy, MI 48084
Phone (248) 824-6060

Organizations & group practices 4

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": "1679443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1649973538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50505 SCHOENHERR RD STE 270",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483153141",
            "telephone_number": "586-323-6058",
            "fax_number": "586-500-8865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50505 SCHOENHERR RD STE 270",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483153141",
            "telephone_number": "586-323-6058",
            "fax_number": "586-500-8865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44201 Dequindre Rd",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480851117",
            "country_code": "US",
            "telephone_number": "248-964-8520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAWORSKI",
        "first_name": "ALYSSA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-22",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "MI",
            "license": "4704354057",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704354057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

Verify at the official NPI Registry.