REBECCA L KRZYSIAK (NP) – Nurse Practitioner, NPI 1023668951

REBECCA L KRZYSIAK (NP) is a healthcare provider. based in Niles, Michigan. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 4704271704 (MI). The NPI Number for REBECCA L KRZYSIAK (NP) is 1023668951

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
REBECCA L KRZYSIAK (NP)
NPI
1023668951
Phone
(269) 687-4673
Address
42 N SAINT JOSEPH AVE STE 101
Enumeration Date
12 September 2019
Last Update Date
26 October 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2696874673
Graduation Year
2019 (7 years ago)
PAC ID
7517395932
Group Practice PAC ID
1658427042
Professional Enrollment ID
I20200318002381
Address ID
MI491202203NI42XXXAVEX502
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

8,105 NURSE PRACTITIONER in MI

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Provider Addresses for REBECCA L KRZYSIAK (NP)

  • North Saint Joseph Avenue, Niles, Berrien County, Michigan, 49120, United States

    NILES, MI 491202203

    Phone: (269) 687-4673

    Fax: (269) 687-1798

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $63.

Total Amount is formed as General ($63) + Research ($0) + Ownership ($0) = $63.

Last reported payment date: 2024-06-27 • Largest payer in this snapshot: Novo Nordisk Inc ($63).

Total Amount

$63

General + Research + Ownership

Payments

3

Total payment records

General Amount

$63

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-06-27

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Novo Nordisk Inc$63
View all Open Payments →|Open Payments Risk Radar →

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: 2020-03-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200318002381INurse PractitionerMITBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49120)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1658427042View full group profile
NameSpecialtyState
-MI
Nurse PractitionerMI
-MI
-MI
Physician AssistantMI
-MI
Physician AssistantMI
Internal MedicineMI
O B S T E T R I C S/ G Y N E C O L O G YMI
Nurse PractitionerMI

Reviews

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Frequently asked questions

Does REBECCA L KRZYSIAK (NP) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — REBECCA L KRZYSIAK (NP) uses 1023668951.
Can I rely on REBECCA L KRZYSIAK (NP) being an active provider?
As of the registry snapshot, REBECCA L KRZYSIAK (NP) is marked active.
What is REBECCA L KRZYSIAK (NP) best known for clinically?
Directory data describes REBECCA L KRZYSIAK (NP) with Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What address line appears for REBECCA L KRZYSIAK (NP)?
REBECCA L KRZYSIAK (NP)'s geographic hint is Niles, Michigan in our summary view.
Why does REBECCA L KRZYSIAK (NP) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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