Alexandra Marie Menillo, D.O.

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

5101026148 Issued in MI

Practice address

25 Michigan St NE Ste 4200
Grand Rapids, MI 49503-2559

Phone

(616) 267-9150

NPI assigned

Apr 7, 2017

Last updated

Dec 1, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pediatric Medicine

Education

Kansas City University of Med & Biosciences, College of Osteo Med, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University PediatriciansGroup PAC ID 9638070568, 121 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Children's Hospital of Michigan Hospital, Detroit, MI, CCN 233300

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.hfhs.org/FHIRProxy/api/FHIR/R4/

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.

• University Pediatricians

  • Pediatrics Physician
  • Detroit, MI
  • NPI 1811920549
  Medicare reassignment Care Compare group NPD
• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Medicare reassignment NPD
• Henry Ford Macomb Hospital Corporation

  dba Henry Ford Macomb Family Medicine

  • Family Medicine Physician
  • Clinton TWP, MI
  • NPI 1134265986

  Pediatrics

  Medicare reassignment NPD
• Spectrum Health Primary Care Partners

  dba Corewell Health Medical Group West

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1235188673

  Pediatric Cardiology

  Medicare reassignment NPD
• Wa Foote Memorial Hospital, Inc

  dba Henry Ford Allegiance Health

  • Nurse Practitioner
  • Jackson, MI
  • NPI 1629000708
  Medicare reassignment NPD
• Hurley Medical Center

  dba Hurley OB/GYN Research & Education

  • Obstetrics & Gynecology Physician
  • Flint, MI
  • NPI 1982630844
  Medicare reassignment
• Henry Ford Health System

  • Anesthesiology Physician
  • Detroit, MI
  • NPI 1003989690
  NPD
• Henry Ford Health System

  • Podiatrist
  • Detroit, MI
  • NPI 1396824207
  NPD
• Henry Ford Health System

  • Community/Retail Pharmacy
  • Plymouth, MI
  • NPI 1942931720
  NPD
• Henry Ford Health System

  • Cardiovascular Disease Physician
  • Detroit, MI
  • NPI 1982787487

  Pediatric Cardiology

  NPD
• Henry Ford Macomb Hospital Corporation

  dba Henry Ford Health Macomb Hospital

  • General Acute Care Hospital
  • Clinton TWP, MI
  • NPI 1023114634
  NPD
• Spectrum Health Primary Care Partners

  dba Corewell Health Medical Group West

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1689499667
  NPD

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

• VHS Childrens Hospital of Michigan Inc

  dba Childrens Hospital of Michigan

  • Children's Hospital
  • Detroit, MI
  • NPI 1538471800
  Care Compare affiliation

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

{
    "created_epoch": "1491523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1770016636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450",
            "telephone_number": "313-874-4806",
            "fax_number": "313-876-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MICHIGAN ST NE STE 4200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032559",
            "telephone_number": "616-267-9150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2799 W Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482022689",
            "country_code": "US",
            "telephone_number": "313-916-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENILLO",
        "first_name": "ALEXANDRA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-07",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101026148",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MI",
            "license": "5101026148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tenagne Mengistu
• Mehreteab Yacob Mengsteab, MD
• Lesley Nicole Menhart, MSW
• Marissa Menichini
• La Quinn Menier, CCM
• Menuez Holistic Counseling
• Andrew D Mepham, PA-C
• Terica Mercado
• Allison Elizabeth Mercer, LLMSW
• Corbin Merchant, MD

• Pediatric Cardiology Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Pediatric Cardiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2025; 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.