NPIMap

Individual provider Active NPI

Alyse Marie Alexander, CNP

  • Family Nurse Practitioner
  • Genoa, OH
National Provider Identifier
1902586068
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0033823 Issued in OH
Practice address
22614 State Route 51 W
Genoa, OH 43430-1143
Phone
(419) 855-7772
NPI assigned
Jul 24, 2023
Last updated
Dec 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0033823 OH Primary
Family Nurse Practitioner 363LF0000X 4704407240 MI

Addresses

Primary practice location

22614 State Route 51 W
Genoa, OH 43430-1143

Mailing address

1115 Country View LN Apt 16C
Toledo, OH 43615-8310
Phone (828) 447-4149

Other names 1

  • Alyse Marie Bulleit Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230811001000 MI Practitioner - Nurse Practitioner 0547622219 Reassigns benefits to 1 organization
I20230822003929 OH Practitioner - Nurse Practitioner 0547622219 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

22614 State Route 51 W
Genoa, OH 43430-1143
Phone (419) 855-7772

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.23 of 100Reported as group
Quality
59.13
Promoting interoperability
99
Improvement activities
40
Cost
75.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0033823OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Ohio Medical Specialists LLC CurrentSince Aug 5, 2024 Accepting new patients
Northern Ohio Medical Specialists, LLC CurrentSince Aug 5, 2024 Accepting new patients
Northern Ohio Medical Specialists, LLC Past Accepting new patients
West Toledo Urgent Care LLC Past Accepting new patients

Locations

22614 W State Route 51
Genoa, OH 43430
Phone (419) 855-7772

3004 Hayes Ave
Sandusky, OH 44870
Phone (419) 625-2841

Interoperability endpoints

  • Direct secure messaging: abulleit30215@nomshealthcare.direct-ci.com

Organizations & group practices 6

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1690156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1902586068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 COUNTRY VIEW LN APT 16C",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436158310",
            "telephone_number": "828-447-4149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22614 STATE ROUTE 51 W",
            "city": "GENOA",
            "state": "OH",
            "postal_code": "434301143",
            "telephone_number": "419-855-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER",
        "first_name": "ALYSE",
        "middle_name": "MARIE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-24",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0033823",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704407240",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSE",
            "last_name": "BULLEIT",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Genoa, OH

Sources for this page

Verify at the official NPI Registry.