Active NPI
Michele Leann Elvander, MPT
- Pediatric Physical Therapist
- Costa Mesa, CA
National Provider Identifier
1053707281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 26731
- Practice address
- 3124 Taft Way
Costa Mesa, CA 92626-2708 - Phone
- (562) 397-4871
- NPI assigned
- Apr 14, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 26731 | CA | Primary |
Addresses
Primary practice location
3124 Taft Way
Costa Mesa, CA 92626-2708
Mailing address
3124 Taft Way
Costa Mesa, CA 92626-2708
Phone (562) 397-4871
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26731 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428969600000",
"number": "1053707281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3124 TAFT WAY",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926262708",
"telephone_number": "562-397-4871"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3124 TAFT WAY",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926262708",
"telephone_number": "562-397-4871"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELVANDER",
"first_name": "MICHELE",
"middle_name": "LEANN",
"name_prefix": "Mrs.",
"credential": "MPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-14",
"last_updated": "2015-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "CA",
"license": "26731",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.