Individual provider Active NPI

Michelle Opsahl, M.D.

  • Family Medicine Physician
  • Loma Linda, CA
National Provider Identifier
1083728729
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A63908 Issued in CA
Practice address
25455 Barton Rd
Ste. 204a
Loma Linda, CA 92354-3128
Phone
(909) 558-6600
NPI assigned
Aug 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A63908 CA Primary

Addresses

Primary practice location

25455 Barton Rd
Ste. 204a
Loma Linda, CA 92354-3128

Mailing address

54701 File Number
Los Angeles, CA 90074-4701
Phone (909) 558-3111

Other identifiers 1

IdentifierTypeStateIssuer
00A639080MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180322001952 TX Practitioner - Family Practice 3577697762 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside-San Bernardino County Indian Health, Inc CurrentSince Feb 12, 2018 Accepting new patients
Riverside-San Bernardino County Indian Health, Inc. Current Accepting new patients
Riverside-San Bernardino County Indian Health, Inc. CurrentSince Feb 12, 2018 Accepting new patients

Locations

11555 Potrero Rd
#1-2
Banning, CA 92220
Phone (909) 849-4761

11980 Mount Vernon Ave
Grand Terrace, CA 92313
Phone (909) 783-8470

23119 Soboba Rd
San Jacinto, CA 92583
Phone (951) 654-0803

Interoperability endpoints

  • Direct secure messaging: michelle.opsahl.1@3408.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Compassionate Care HospiceRiverside, CA, CCN A01762 Hospice Operational/Managerial Control (100%) Apr 22, 2026

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083728729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54701 FILE NUMBER",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900744701",
            "telephone_number": "909-558-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25455 BARTON RD",
            "address_2": "STE. 204A",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543128",
            "telephone_number": "909-558-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPSAHL",
        "first_name": "MICHELLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A63908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A639080",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.