Individual provider Active NPI

Michelle A Cleary, N.P.

  • Nurse Practitioner
  • Pleasant Hill, CA
National Provider Identifier
1093734527
Registry record updated Jun 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP8668 Issued in CA
Practice address
380 Civic Dr
Suite 100
Pleasant Hill, CA 94523-1988
Phone
(925) 682-7871
Fax
(925) 682-7874
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2012

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 NP8668 CA Primary

Addresses

Primary practice location

380 Civic Dr
Suite 100
Pleasant Hill, CA 94523-1988

Mailing address

Dept 34929
P.O. Box 39000
San Francisco, CA 94139-0001
Phone (925) 952-2828

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
I20050222000777 CA Practitioner - Nurse Practitioner 9032162722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
John Muir Physician NetworkGroup PAC ID 6608789813, 488 clinicians

Practice addresses (Care Compare)

2400 Balfour Rd
Suite 120
Brentwood, CA 94513-4956
Phone (925) 308-8112

2675 Pleasant Hill Rd
Pleasant Hill, CA 94523-2033
Phone (925) 692-5520

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP8668CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
John Muir Physician Network CurrentSince Mar 30, 2016 Accepting new patients

Locations

2400 Balfour Rd
Ste 120
Brentwood, CA 94513
Phone (925) 308-8112

380 Civic Dr
Ste 100
Pleasant Hill, CA 94523
Phone (925) 284-3840

1450 Treat Blvd
Ste 300
Walnut Creek, CA 94597

Organizations & group practices 1

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 2

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339977600000",
    "number": "1093734527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 34929",
            "address_2": "P.O. BOX 39000",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941390001",
            "telephone_number": "925-952-2828",
            "fax_number": "925-952-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 CIVIC DR",
            "address_2": "SUITE 100",
            "city": "PLEASANT HILL",
            "state": "CA",
            "postal_code": "945231988",
            "telephone_number": "925-682-7871",
            "fax_number": "925-682-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEARY",
        "first_name": "MICHELLE",
        "middle_name": "A",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2012-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP8668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Hill, CA

Sources for this page

Verify at the official NPI Registry.