ALYSSA M WOODBURY (PA-C) – Physician Assistant, NPI 1013357318
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
6,069 PHYSICIAN ASSISTANT in MI
Provider Addresses for ALYSSA M WOODBURY (PA-C)
28411 NORTHWESTERN HWY
SUITE 740
SOUTHFIELD, MI 480345544
Phone: (248) 455-0865
Type: Mailing
1 WILLIAM CARLS DR
SUITE 120
COMMERCE TOWNSHIP, MI 483822201
Phone: (248) 937-4947
Type: Location
98 POPLAR ST
BLACKFOOT, ID 832211799
Phone:
Type: Mailing
P.O. BOX 4168
POCATELLO, ID 832054168
Phone: (208) 239-1035
Fax: (208) 239-3626
Type: Mailing
777 HOSPITAL WAY
POCATELLO, ID 832015175
Phone: (208) 239-1226
Fax: (208) 239-3671
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $14.
Total Amount is formed as General ($14) + Research ($0) + Ownership ($0) = $14.
Last reported payment date: 2023-05-30 • Largest payer in this snapshot: Bioventus LLC ($14).
Total Amount
$14
General + Research + Ownership
Payments
1
Total payment records
General Amount
$14
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-05-30
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Bioventus LLC | $14 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-09-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20191001001730 | I | Physician Assistant | WI | TBD |
| I20240926004364 | I | Physician Assistant | ID | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 23472 | Prosthetic repair of shoulder joint, total shoulder | 12 | 11 | $0 |
Insurance plans in this area (ZIP 48034)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| N E U R O S U R G E R Y | WA | |
| Internal Medicine | ID | |
| Qualified Audiologist | ID | |
| Thoracic Surgery, Cardiac Surgery | ID | |
| Family Practice | ID | |
| Physician Assistant | ID | |
| Cardiovascular Disease (Cardiology), Cardiac Electrophysiology | MI | |
| Physician Assistant | ID | |
| - | ID | |
| Physician Assistant | NY |
Reviews
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