Mary Disselkoen
NPI 1457596090ActiveIndividual· Audiologist· Grand Rapids, MI
Audiologist in Grand Rapids, Michigan, licensed in MI, with an NPI issued in December 2008.
Overview
| NPI | 1457596090 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Dec 11, 2008 |
| Last updated in NPPES | Dec 11, 2008 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Audiologist Primary | 231H00000X | 1601000230 | MI |
| Audiologist, Assistive Technology Practitioner | 231HA2400X | 1601000230 | MI |
| Audiologist-Hearing Aid Fitter | 237600000X | 1601000230 | MI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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