Individual provider Active NPI

Alyssa Fabrizio

  • Student in an Organized Health Care Education/Training Program
  • Detroit, MI
National Provider Identifier
1871383554
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
4201 Saint Antoine St Ste 5B
Detroit, MI 48201-2153
Phone
(313) 996-0639
Fax
(313) 745-8165
NPI assigned
May 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 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

4201 Saint Antoine St Ste 5B
Detroit, MI 48201-2153

Mailing address

15988 Ryland
Redford, MI 48239-3951

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260612000654 MI Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 4688146483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1746576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1871383554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15988 RYLAND",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482393951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST STE 5B",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-996-0639",
            "fax_number": "313-745-8165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABRIZIO",
        "first_name": "ALYSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-07",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "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 Detroit, MI

Sources for this page

Verify at the official NPI Registry.