NPIMap

Individual provider Active NPI

Elizabeth Todd Embick, M.D.

  • Surgery Physician
  • Grand Rapids, MI
National Provider Identifier
1902210081
Registry record updated Jun 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4301105795 Issued in MI
Practice address
221 Michigan St NE # Mc106
Grand Rapids, MI 49503-2543
Phone
(616) 391-1691
Fax
(616) 391-8611
NPI assigned
Jun 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4301105795 MI Primary

Addresses

Primary practice location

221 Michigan St NE # Mc106
Grand Rapids, MI 49503-2543

Mailing address

221 Michigan St NE # Mc106
Grand Rapids, MI 49503-2543
Phone (616) 391-1691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190919000338 TX Practitioner - General Surgery 8921223009 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Washington School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4315 Diplomacy Dr
Anchorage, AK 99508-5926
Phone (907) 563-2662

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.93 of 100Reported as group
Quality
70.1
Promoting interoperability
100
Improvement activities
40
Cost
83.01

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy33
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux11
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301105795MIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corportation Current Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Aug 22, 2019 Accepting new patients
Bristol Bay Area Health Corporation CurrentSince Mar 1, 2025 Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corportion Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation CurrentSince Mar 1, 2025 Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corportion Current Accepting new patients
Alaska Native Tribal Health Consortium Past Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

Interoperability endpoints

  • Direct secure messaging: etembick@direct.anthc.org

Organizations & group practices 22

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.

View all 22

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402963200000",
    "number": "1902210081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 MICHIGAN ST NE # MC106",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032543",
            "telephone_number": "616-391-1691",
            "fax_number": "616-391-8611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 MICHIGAN ST NE # MC106",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032543",
            "telephone_number": "616-391-1691",
            "fax_number": "616-391-8611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMBICK",
        "first_name": "ELIZABETH",
        "middle_name": "TODD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-17",
        "last_updated": "2014-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301105795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.