Individual provider Active NPI

Nicholas Kurz Pryde, MD

  • Student in an Organized Health Care Education/Training Program
  • Elk Rapids, MI
National Provider Identifier
1790571040
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
PO Box 474
Elk Rapids, MI 49629-0474
Phone
(248) 892-8933
NPI assigned
Apr 15, 2025
Last updated
Apr 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

PO Box 474
Elk Rapids, MI 49629-0474

Mailing address

PO Box 474
Elk Rapids, MI 49629-0474
Phone (248) 892-8933

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20250619000034 LA Order and Referring Only - OphthalmologyPractitioner - Ophthalmology 6002327707

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1744675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1790571040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 474",
            "city": "ELK RAPIDS",
            "state": "MI",
            "postal_code": "496290474",
            "telephone_number": "248-892-8933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 474",
            "city": "ELK RAPIDS",
            "state": "MI",
            "postal_code": "496290474",
            "telephone_number": "248-892-8933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRYDE",
        "first_name": "NICHOLAS",
        "middle_name": "KURZ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-15",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Rapids, MI

Sources for this page

Verify at the official NPI Registry.