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MIKAELA NICOLE GRUDZIEN MD
NPI 1619767456
Student in an Organized Health Care Education/Training Program in White Lake, MI

Active since May 06, 2025PECOS Enrolled
8465 EASTWAY DR, WHITE LAKE, MI 48386(248) 931-4174 Get Directions Write a Review

NPPES record last updated: May 6, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mikaela Nicole Grudzien Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIKAELA NICOLE GRUDZIEN MD (NPI 1619767456) is an individual student in an organized health care education/training program in White Lake, Michigan and active in the NPI registry since May 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619767456
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameMIKAELA NICOLE GRUDZIENCredential: MD
Location Address8465 EASTWAY DRWhite Lake, MI 48386-3584
Mailing Address8465 Eastway DrWhite Lake, MI 48386-3584 · (248) 931-4174
Phone(248) 931-4174
Sole ProprietorNo
Enumeration DateMay 6, 2025
NPPES CertifiedMay 6, 2025
✔ NPI 1619767456 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
8465 EASTWAY DR, White Lake, MI 48386
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mikaela Nicole Grudzien Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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 Mikaela Grudzien's NPI number?

The NPI number for Mikaela Grudzien is 1619767456. It was assigned to this individual provider in the NPPES registry on May 6, 2025.

Where is Mikaela Grudzien located?

Mikaela Grudzien practices at 8465 Eastway Dr, White Lake, MI 48386. The listed phone number is (248) 931-4174.

What is Mikaela Grudzien's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Mikaela Grudzien enrolled in Medicare?

Yes. Mikaela Grudzien is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mikaela Grudzien was last updated on May 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.