Individual provider Active NPI

Michelle Jessica Carhill, NP

  • Nurse Practitioner
  • Upland, CA
National Provider Identifier
1023873759
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95029161 Issued in CA
Practice address
585 N Mountain Ave
Upland, CA 91786-8516
Phone
(909) 608-7546
NPI assigned
Feb 21, 2024
Last updated
Mar 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95029161 CA Primary

Addresses

Primary practice location

585 N Mountain Ave
Upland, CA 91786-8516

Mailing address

6951 Roma PL
Rancho Cucamonga, CA 91701-8542
Phone (909) 938-0876

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240815003229 CA Practitioner - Nurse Practitioner 9133667587 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Ohio State University College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Island Dermatology, Inc.Group PAC ID 1850395070, 27 clinicians

Practice addresses (Care Compare)

210 S Grand Ave
Suite 208
Glendora, CA 91741-4266
Phone (626) 914-3675

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95029161CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Island Dermatology, Inc CurrentSince Jun 1, 2024 Accepting new patients
Hai Tran, M.D., Inc. Current Accepting new patients

Locations

8345 Firestone Blvd
Ste 310
Downey, CA 90241
Phone (562) 923-3001

210 S Grand Ave
Ste 208
Glendora, CA 91741
Phone (626) 914-3675

12611 Hesperia Rd
Ste A
Victorville, CA 92395
Phone (442) 255-4130

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1708473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1023873759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6951 ROMA PL",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917018542",
            "telephone_number": "909-938-0876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 N MOUNTAIN AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917868516",
            "telephone_number": "909-608-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARHILL",
        "first_name": "MICHELLE",
        "middle_name": "JESSICA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-21",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95029161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.