Individual provider Active NPI

Michelle A Bholat, MD

  • Family Medicine Physician
  • Riverside, CA
National Provider Identifier
1104849959
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G77772 Issued in CA
Practice address
3390 University Ave Ste 100
Riverside, CA 92501-3315
Phone
(844) 827-8000
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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 G77772 CA Primary

Addresses

Primary practice location

3390 University Ave Ste 100
Riverside, CA 92501-3315

Mailing address

3390 University Ave Ste 100
Riverside, CA 92501-3315
Phone (844) 827-8000

Other identifiers 1

IdentifierTypeStateIssuer
00G777720MedicaidCA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051025001094 CA Practitioner - Family Practice 1850318296 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Irvine, California College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3390 University Ave
Suite 100
Riverside, CA 92501-3315
Phone (951) 827-7793

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G77772CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Family Medicine CurrentSince Dec 18, 2024 Accepting new patients
Ucr Health - Psychiatry CurrentSince Dec 18, 2024 Accepting new patients
UCLA Family Practice Family Medicine Past Accepting new patients
UCLA Medical Group Family Medicine Past Accepting new patients

Locations

3390 University Ave
Ste 100
Riverside, CA 92501
Phone (844) 827-8000

3390 University Ave
Riverside, CA 92501
Phone (951) 447-4697

3390 University Ave
Ste 1
Riverside, CA 92501
Phone (951) 827-7793

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1104849959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3390 UNIVERSITY AVE STE 100",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013315",
            "telephone_number": "844-827-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3390 UNIVERSITY AVE STE 100",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013315",
            "telephone_number": "844-827-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHOLAT",
        "first_name": "MICHELLE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G77772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G777720",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.