DR. ALYSE MICHELLE VICTOR (MD) – Obstetrics Physician, NPI 1548840630

DR. ALYSE MICHELLE VICTOR (MD) is a healthcare provider. based in Roseville, Michigan. specializing in OBSTETRICS/GYNECOLOGY. They hold the professional credentials MD. They hold a License No. 4301513703 (MI). The NPI Number for DR. ALYSE MICHELLE VICTOR (MD) is 1548840630

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
DR. ALYSE MICHELLE VICTOR (MD)
NPI
1548840630
Phone
(586) 415-6200
Address
29751 LITTLE MACK AVE STE B
Enumeration Date
12 April 2021
Last Update Date
5 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5864156200
Graduation Year
2020 (6 years ago)
PAC ID
1658887419
Group Practice PAC ID
2466543640
Professional Enrollment ID
I20250719000409
Address ID
MI480666504RO29751AVEX402

Contacts

Other Endpoint
https://www.numc.edu/
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness95
Years active:5State licenses:1Other names

3,472 OBSTETRICS/GYNECOLOGY in NY

Provider Addresses for DR. ALYSE MICHELLE VICTOR (MD)

  • 29751 LITTLE MACK AVE STE B

    ROSEVILLE, MI 480666504

    Phone: (586) 415-6200

    Type: Mailing

  • 2201 HEMPSTEAD TPKE

    EAST MEADOW, NY 115541859

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2025-07-19

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
I20250719000409IObstetrics/GynecologyMITBD

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 48066)

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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: 2466543640View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YMI
Certified Nurse Midwife (Cnm)MI
O B S T E T R I C S/ G Y N E C O L O G YMI
O B S T E T R I C S/ G Y N E C O L O G YMI
Nurse PractitionerMI
O B S T E T R I C S/ G Y N E C O L O G YMI
O B S T E T R I C S/ G Y N E C O L O G YMI
O B S T E T R I C S/ G Y N E C O L O G YMI
Physician AssistantMI
O B S T E T R I C S/ G Y N E C O L O G YMI

Reviews

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Frequently asked questions

Can I use this page to confirm DR. ALYSE MICHELLE VICTOR (MD)'s NPI?
Yes. DR. ALYSE MICHELLE VICTOR (MD) is listed with NPI 1548840630 in the public NPI dataset.
Does CMS list DR. ALYSE MICHELLE VICTOR (MD) as active?
Yes — DR. ALYSE MICHELLE VICTOR (MD) is active in the NPI listing used on this page.
What healthcare role does DR. ALYSE MICHELLE VICTOR (MD) hold?
Scheduling teams often label DR. ALYSE MICHELLE VICTOR (MD) under Obstetrics Physician. Clinical services aligned with this taxonomy classification.
Where should I expect DR. ALYSE MICHELLE VICTOR (MD) on a map?
Expect Roseville, Michigan as a primary anchor for DR. ALYSE MICHELLE VICTOR (MD) unless the record lists multiple sites.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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