Dr Alyssa Fedorko, MD/PHD is a medicare enrolled "Physical Medicine & Rehabilitation" physician in Greenville, Michigan. Her current practice location is
707 S Greenville West Dr, Greenville, Michigan. You can reach out to her office (for appointments etc.) via phone at
(616) 754-3001.
Dr Alyssa Fedorko is licensed to practice in Michigan (license number 4301512074) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1811516511.
Physician's Profile
| Full Name | Dr Alyssa Fedorko |
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| Gender | Female |
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| Speciality | Physical Medicine & Rehabilitation |
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| Location | 707 S Greenville West Dr, Greenville, Michigan |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1811516511
- Provider Enumeration Date: 04/13/2020
- Last Update Date: 09/03/2024
Medicare PECOS Information:
- PECOS PAC ID: 9638593619
- Enrollment ID: I20240710005068
Medical Identifiers
Medical identifiers for Dr Alyssa Fedorko such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1811516511 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208100000X | Physical Medicine & Rehabilitation | 4301512074 (Michigan) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Alyssa Fedorko allows following entities to bill medicare on her behalf.
| Entity Name | Spectrum Health United |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1457304495
PECOS PAC ID: 6305836487
Enrollment ID: O20040612000087 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Alyssa Fedorko is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Alyssa Fedorko, MD/PHD
100 Michigan St Ne # Mc845,
Grand Rapids, MI 49503-2560
Ph: () - | Dr Alyssa Fedorko, MD/PHD
707 S Greenville West Dr,
Greenville, MI 48838-3514
Ph: (616) 754-3001 |
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