Active NPI
Anne T Mishica, D.O.
- Family Medicine Physician
- Palm Springs, CA
National Provider Identifier
1124031307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 20A6012
- Practice address
- 3111 E Tahquitz Canyon Way
Palm Springs, CA 92262-6956 - Phone
- (760) 778-2210
- Fax
- (760) 778-2214
- NPI assigned
- Aug 15, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20A6012 | CA | Primary |
Addresses
Primary practice location
3111 E Tahquitz Canyon Way
Palm Springs, CA 92262-6956
Mailing address
PO Box 7849
Riverside, CA 92513-7849
Phone (951) 358-5222
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)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1359 | WA | MD | Paramedic |
| 20A6012 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nooksack Central Management System | Family Medicine | Past | Accepting new patients |
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.
-
- Family Medicine Physician
- Everson, WA
- NPI 1568528842
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1124031307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7849",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925137849",
"telephone_number": "951-358-5222",
"fax_number": "951-358-5235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3111 E TAHQUITZ CANYON WAY",
"city": "PALM SPRINGS",
"state": "CA",
"postal_code": "922626956",
"telephone_number": "760-778-2210",
"fax_number": "760-778-2214"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MISHICA",
"first_name": "ANNE",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-15",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "20A6012",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Springs, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.