Individual provider Active NPI

Alyssa Jontae Trager

  • Clinical Social Worker
  • Kalamazoo, MI
National Provider Identifier
1952929473
Registry record updated Jul 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801103582 Issued in MI
Practice address
2030 Portage St
Kalamazoo, MI 49001-3836
Phone
(269) 553-8056
NPI assigned
Jul 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801103582 MI Primary

Addresses

Primary practice location

2030 Portage St
Kalamazoo, MI 49001-3836

Mailing address

2030 Portage St
Kalamazoo, MI 49001-3836
Phone (269) 553-8056

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220310002286 MI Practitioner - Clinical Social Worker 3678968567 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

615 E Crosstown Pkwy
Kalamazoo, MI 49001-2501
Phone (269) 373-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801103582MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kalamazoo County Community Mental Health Authority CurrentSince Mar 1, 2022 Accepting new patients
Kalamazoo County Community Mental Health Authority CurrentSince Mar 1, 2022 Accepting new patients

Locations

418 W Kalamazoo Ave
Kalamazoo, MI 49007
Phone (269) 373-6000

2030 Portage St
Kalamazoo, MI 49001
Phone (269) 553-7132

615 E Crosstown Pkwy
Kalamazoo, MI 49001
Phone (269) 373-6000

610 S Burdick St
Kalamazoo, MI 49007
Phone (269) 373-6000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1594339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594339200000",
    "number": "1952929473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 PORTAGE ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490013836",
            "telephone_number": "269-553-8056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 PORTAGE ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490013836",
            "telephone_number": "269-553-8056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAGER",
        "first_name": "ALYSSA",
        "middle_name": "JONTAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-10",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801103582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.