Individual provider Active NPI

Michelle Elissa Nagel, PA

  • Physician Assistant
  • San Diego, CA
National Provider Identifier
1033580865
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA64733 Issued in CA
Practice address
16950 Via Tazon
San Diego, CA 92127-1607
Phone
(800) 926-8273
Fax
(888) 539-8781
NPI assigned
Oct 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA64733 CA Primary

Addresses

Primary practice location

16950 Via Tazon
San Diego, CA 92127-1607

Mailing address

File 57326
Los Angeles, CA 90074-7326

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160128002496 IL Practitioner - Physician Assistant 7214230911 Reassigns benefits to 4 organizations
I20250915003139 CA Practitioner - Physician Assistant 7214230911 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
UC San Diego Health Community GroupGroup PAC ID 3971849175, 109 clinicians

Practice addresses (Care Compare)

16950 Via Tazon
San Diego, CA 92127-1607
Phone (800) 926-8273

Hospital & facility affiliations

  • UC San Diego Health Hillcrest - Hillcrest Med Ctr Hospital, San Diego, CA, CCN 050025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA64733CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Headache Lab CurrentSince Dec 29, 2015 Accepting new patients
Innovative Medspa PLLC PastSince Jun 2, 2024 Accepting new patients

Locations

9760 S Kedzie Ave
Ste 3
Evergreen Pk, IL 60805
Phone (708) 423-6209

9760 S Kedzie Ave
Ste 2
Evergreen Pk, IL 60805
Phone (708) 423-8150

Interoperability endpoints

  • Direct secure messaging: michelle.nagel.1@13676.direct.athenahealth.com

Organizations & group practices 7

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1445299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1033580865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE 57326",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900747326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16950 VIA TAZON",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921271607",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGEL",
        "first_name": "MICHELLE",
        "middle_name": "ELISSA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-20",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA64733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.