Alicia Beth Vanden Bussche Jantz, PHD is a medicare enrolled "Clinical Neuropsychologist" provider in Grand Rapids, Michigan. Her current practice location is
275 Michigan St Ne, Grand Rapids, Michigan. You can reach out to her office (for appointments etc.) via phone at
(616) 267-7401.
Alicia Beth Vanden Bussche Jantz is licensed to practice in Michigan (license number 6301018407) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1144678020.
Healthcare Provider's Profile
Full Name | Alicia Beth Vanden Bussche Jantz |
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Gender | Female |
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Speciality | |
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Experience | Years |
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Location | 275 Michigan St Ne, Grand Rapids, Michigan |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Alicia Beth Vanden Bussche Jantz attended and graduated from in
NPI Data:
- NPI Number: 1144678020
- Provider Enumeration Date: 06/01/2016
- Last Update Date: 12/09/2024
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Alicia Beth Vanden Bussche Jantz such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1144678020 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
103TC0700X | Psychologist - Clinical | 6301018407 (Michigan) | Secondary |
103G00000X | Clinical Neuropsychologist | 6301018407 (Michigan) | Primary |
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. Alicia Beth Vanden Bussche Jantz 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 |
Alicia Beth Vanden Bussche Jantz, PHD 100 Michigan St Ne # Mc845, Grand Rapids, MI 49503-2560 Ph: () - | Alicia Beth Vanden Bussche Jantz, PHD 275 Michigan St Ne, Grand Rapids, MI 49503-2531 Ph: (616) 267-7401 |
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