Elyse C Van Ittersum, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704341270 Issued in MI

Practice address

4060 Rochester Rd
Troy, MI 48085-4923

Phone

(248) 250-6420

Fax

(248) 250-6430

NPI assigned

Sep 18, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Elyse C Rexer Former name

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

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellstreet Urgent Care of MichiganGroup PAC ID 6305188491, 129 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
• Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269

Merit-based Incentive Payment System (MIPS)

Final score

76.04 of 100Reported as group

Quality

67.93

Promoting interoperability

100

Improvement activities

40

Cost

52.21

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Wellstreet Urgent Care of Michigan

  • Urgent Care Clinic/Center
  • West Bloomfield, MI
  • NPI 1578048096

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Canton Urgent Care Walk-in Clinic PC

  • Urgent Care Clinic/Center
  • Canton, MI
  • NPI 1649712480

  Single Specialty

  Medicare reassignment NPD
• Chesterfield Urgent Care Walk-in Clinic

  • Urgent Care Clinic/Center
  • Chesterfield, MI
  • NPI 1629547195

  Single Specialty

  Medicare reassignment NPD
• Clinton Urgent Care Walk-in Clinic

  • Family Medicine Physician
  • Clinton Township, MI
  • NPI 1831610070

  Single Specialty

  Medicare reassignment NPD
• Commerce Urgent Care Walk-in Clinic

  • Urgent Care Clinic/Center
  • Commerce TWP, MI
  • NPI 1952823825

  Single Specialty

  Medicare reassignment NPD
• Doctors Urgent Care Southfield

  • Urgent Care Clinic/Center
  • Southfield, MI
  • NPI 1326660929

  Single Specialty

  Medicare reassignment NPD
• Rochester Urgent Care Walk-in Clinic

  • Urgent Care Clinic/Center
  • Rochester Hills, MI
  • NPI 1225554694

  Single Specialty

  Medicare reassignment NPD
• Shelby Urgent Care Walk-in Clinic

  • Family Medicine Physician
  • Shelby TWP, MI
  • NPI 1285155119

  Single Specialty

  Medicare reassignment NPD
• Sterling Heights Urgent Care Walk-in Clinic

  • Urgent Care Clinic/Center
  • Sterling Heights, MI
  • NPI 1912413949

  Single Specialty

  Medicare reassignment NPD
• Taylor Urgent Care PC

  • Urgent Care Clinic/Center
  • Taylor, MI
  • NPI 1013321033

  Single Specialty

  Medicare reassignment NPD
• Troy Urgent Care Walk-in Clinic

  • Urgent Care Clinic/Center
  • Troy, MI
  • NPI 1720571227

  Single Specialty

  Medicare reassignment NPD
• Best Urgent Care PC

  • Urgent Care Clinic/Center
  • Redford, MI
  • NPI 1952791105
  Medicare reassignment

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

• William Beaumont Hospital

  • General Acute Care Hospital
  • Troy, MI
  • NPI 1306825997
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Royal Oak, MI
  • NPI 1689653305
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Grosse Pointe, MI
  • NPI 1932396017
  Care Compare affiliation

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

{
    "created_epoch": "1600387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1730795485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6058 HEARTHSIDE DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480985363",
            "telephone_number": "248-765-6535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 ROCHESTER RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480854923",
            "telephone_number": "248-250-6420",
            "fax_number": "248-250-6430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN ITTERSUM",
        "first_name": "ELYSE",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-18",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704341270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELYSE",
            "last_name": "REXER",
            "middle_name": "C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Neenah Valenzuela, H.I.S
• Mallory Rose Valeri, ATC, LAT
• Value Health Laboratory LLC
• Azeldri Van Der Wath, LCSW
• Samantha Ann Van Every
• Lisa Van-Le
• Ryan Vanbommel, DC
• Brittany Vanbuskirk, D.D.S.
• David Vandenberg, M.D.
• Erin Rachel Vandenberg, PA-C

• Family Nurse Practitioner in Troy, MI
• Providers in Troy, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; 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.