Individual provider Active NPI

Larisa Chernishuk, NP, FNP-BC, FNP-C

  • Family Nurse Practitioner
  • Pontiac, MI
National Provider Identifier
1720730039
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704314636 Issued in MI
Practice address
462 N Telegraph Rd
Pontiac, MI 48341-1037
Phone
(248) 234-7540
NPI assigned
Jan 19, 2022
Last updated
Jan 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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 4704314636 MI Primary

Addresses

Primary practice location

462 N Telegraph Rd
Pontiac, MI 48341-1037

Mailing address

PO Box 746723
Atlanta, GA 30374-6723
Phone (312) 733-9730

Other practice location 1

3990 John R St
Detroit, MI 48201-2018
Phone (313) 745-2277

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
I20230126000759 MI Practitioner - Nurse Practitioner 6901277185 Reassigns benefits to 1 organization

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
Osh Mi Physicians Group, PCGroup PAC ID 7810282191, 154 clinicians

Practice addresses (Care Compare)

3525 Saginaw Rd
Burton, MI 48529
Phone (810) 222-3040

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Osh-Mi Physicians Group PC CurrentSince Mar 6, 2023 Accepting new patients
Osh Mi Physicians Group, PC CurrentSince Mar 6, 2023 Accepting new patients
Osh-Mi Physicians Group PC Family Past Accepting new patients

Locations

102 W Pierson Rd
Flint, MI 48505
Phone (810) 222-3033

462 N Telegraph Rd
Pontiac, MI 48341
Phone (248) 234-7540

Interoperability endpoints

  • Direct secure messaging: lchernishuk1072705@direct.hfhs.org

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 2

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": "1642550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1720730039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746723",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746723",
            "telephone_number": "312-733-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 N TELEGRAPH RD",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483411037",
            "telephone_number": "248-234-7540"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3990 John R St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012018",
            "country_code": "US",
            "telephone_number": "313-745-2277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHERNISHUK",
        "first_name": "LARISA",
        "name_prefix": "Ms.",
        "credential": "NP, FNP-BC, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-19",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704314636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.