ALYSA MICHELLE CLARK MD
NPI 1356903371
Emergency Medicine - Pediatric Emergency Medicine in Grand Rapids, MI
About Alysa Michelle Clark Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ALYSA MICHELLE CLARK MD (NPI 1356903371) is an individual pediatric emergency medicine provider in Grand Rapids, Michigan, licensed in Michigan (4301504949) and active in the NPI registry since June 2019. She is enrolled in Medicare PECOS, is affiliated with Spectrum Health United Hospital, and is a graduate of Other (2019).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Alysa Michelle Clark Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
3Medicare enrollment records show Alysa Clark reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Grand Rapids, MI 49503
- Reassigned Medicare billing, Michigan enrollment
- 2,446 clinicians in this Medicare group
Grand Rapids, MI 49503
- Reassigned Medicare billing, Michigan enrollment
- 265 clinicians in this Medicare group
Grand Rapids, MI 49503
- Reassigned Medicare billing, Michigan enrollment
- 192 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 2
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Spectrum Health United Hospital
Acute Care Hospitals · Greenville, MISpectrum Health
Acute Care Hospitals · Grand Rapids, MIPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 49503 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Alysa Clark's NPI number?
The NPI number for Alysa Clark is 1356903371. It was assigned to this individual provider in the NPPES registry on June 29, 2019.
Where is Alysa Clark located?
Alysa Clark practices at 100 Michigan St NE # Mc049, Grand Rapids, MI 49503. The listed phone number is (616) 391-1680.
What is Alysa Clark's specialty?
The primary specialty registered for this NPI is Emergency Medicine, specializing in Pediatric Emergency Medicine, with taxonomy code 207PP0204X.
Is Alysa Clark enrolled in Medicare?
Yes. Alysa Clark is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Alysa Clark's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Alysa Clark reassigns Medicare benefits to 3 organizations: Spectrum Health Primary Care Partners (Grand Rapids, MI), Ecs Western Michigan PC (Grand Rapids, MI) and Visionary Medical Services PC (Grand Rapids, MI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Alysa Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Alysa Clark affiliated with any hospitals?
According to CMS data, Alysa Clark is affiliated with Spectrum Health United Hospital and Spectrum Health.
When was this NPI record last updated?
The NPPES record for Alysa Clark was last updated on April 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Alysa Michelle Clark, MD · NPI 1356903371
Pediatric Emergency Medicine physician in Grand Rapids, Michigan. Individual provider, active in the CMS NPPES registry since June 29, 2019.
## Identity
- **NPI:** 1356903371 (Entity type: Individual)
- **Enumerated:** June 29, 2019
- **Primary specialty:** Emergency Medicine - Pediatric Emergency Medicine · taxonomy 207PP0204X
- **State license:** 4301504949 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 100 MICHIGAN ST NE # MC049, Grand Rapids, MI 49503-2560
- **Phone:** (616) 391-1680
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Spectrum Health Primary Care Partners (NPI 1689499667, Grand Rapids, MI); Ecs Western Michigan PC (NPI 1992281000, Grand Rapids, MI); Visionary Medical Services PC (NPI 1538216569, Grand Rapids, MI) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** April 9, 2024
---
Source: [NPI Profile](https://npiprofile.com/npi/1356903371) · Data from the CMS NPPES public registry.