DR. ALISHA RENEE THIBAULT-HLADKI (MD) – Psychiatry Physician, NPI 1295264034
Psychiatry Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,216 PSYCHIATRY in MI
Provider Addresses for DR. ALISHA RENEE THIBAULT-HLADKI (MD)
440 Baltimore Dr NE
Grand Rapids, MI 495033934
Phone: (616) 454-4777
Type: Location
Pine Rest Christian Mental Health Services, 300, 68th Street Southeast, Grand Rapids, Gaines Township, Kent County, Michigan, 49501, United States
PINE REST CHRISTIAN MENTAL HEALTH SERVICES
GRAND RAPIDS, MI 49548
Phone: (616) 456-0842
Fax: (616) 559-5864
Type: Mailing
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 $84.
Total Amount is formed as General ($84) + Research ($0) + Ownership ($0) = $84.
Last reported payment date: 2024-11-19 • Largest payer in this snapshot: ABBVIE INC. ($39).
Total Amount
$84
General + Research + Ownership
Payments
3
Total payment records
General Amount
$84
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $39 |
| E.R. Squibb & Sons, L.L.C. | $25 |
| Janssen Pharmaceuticals, Inc | $19 |
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: 2021-04-01
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210401001227 | I | Psychiatry | MI | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 117 | 52 | $0 |
| 99211 | Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional | 34 | 13 | $0 |
| 90792 | Psychiatric diagnostic evaluation with medical services | 26 | 26 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 25 | 14 | $0 |
Insurance plans in this area (ZIP 49503)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | MI | |
| P S Y C H I A T R Y | MI | |
| Clinical Social Worker | MI | |
| Occupational Therapist In Private Practice | MI | |
| Clinical Social Worker | MI | |
| Clinical Social Worker | MI | |
| Clinical Social Worker | MI | |
| Mental Health Counselor | MI | |
| Nurse Practitioner | MI | |
| Clinical Social Worker | MI |
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