Marisa Anne Konzer, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704342989 Issued in MI

Practice address

45300 Cherry Hill Rd
Canton, MI 48187-5073

Phone

(734) 981-3968

NPI assigned

Jul 12, 2024

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

• Marisa Anne Polsinelli 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

University of Michigan Medical School, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minuteclinic Diagnostic of Michigan PCGroup PAC ID 9133123755, 40 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989

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.

• Minuteclinic Diagnostic of Michigan PC

  • Family Nurse Practitioner
  • Northville, MI
  • NPI 1902848617
  Medicare reassignment Care Compare group NPD
• Minuteclinic Primary Care-Michigan PLLC

  • Family Nurse Practitioner
  • Northville, MI
  • NPI 1528874062
  Medicare reassignment NPD

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

{
    "created_epoch": "1720742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1760229108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2207 MACE AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480672311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45300 CHERRY HILL RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481875073",
            "telephone_number": "734-981-3968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONZER",
        "first_name": "MARISA",
        "middle_name": "ANNE",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-12",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704342989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISA",
            "last_name": "POLSINELLI",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sahithi Kolli, PHARMD
• Elyse Rae Komarzec, MOT, OTR/L
• Kelly Nicole Komis, LLMSW
• Kristin Angela Konn New, MSW
• Gregory Konopka, MA
• Alina Marie Kooperman
• Kenneth L Koorhan, PHARMACIST
• Emad Ragheb Kortam
• Alexis Koska
• Maria Koss

• Family Nurse Practitioner in Canton, MI
• Providers in Canton, 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 Jul 26, 2024; 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.