Individual provider Active NPI

Michael Joseph White, PA-C

  • Physician Assistant
  • Weslaco, TX
National Provider Identifier
1124157540
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA03196 Issued in TX
Practice address
1315 E 6TH St Ste 12
Weslaco, TX 78596-6635
Phone
(956) 447-8377
Fax
(956) 973-8034
NPI assigned
Mar 2, 2007
Sex
Male
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
Physician Assistant 363A00000X PA03196 TX Primary

Addresses

Primary practice location

1315 E 6TH St Ste 12
Weslaco, TX 78596-6635

Mailing address

1315 E 6TH St Ste 12
Weslaco, TX 78596-6635
Phone (956) 447-8377

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20070823000787 MI Practitioner - Physician Assistant 2062513088 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Portage Physician Practices Inc CurrentSince Apr 11, 2017 Accepting new patients
DLP Marquette Physician Practices Inc CurrentSince Sep 1, 2012 Accepting new patients
DLP Marquette Physician Practices Inc CurrentSince Sep 1, 2012 Accepting new patients
Portage Physician Practices Inc CurrentSince Apr 11, 2017 Accepting new patients

Locations

500 Campus Dr
Ste 5
Hancock, MI 49930
Phone (906) 483-1700

420 W Magnetic St
Marquette, MI 49855
Phone (906) 225-3540

1414 W Fair Ave
Ste 344
Marquette, MI 49855
Phone (906) 225-3910

1414 W Fair Ave
Ste 36
Marquette, MI 49855
Phone (906) 225-3864

Organizations & group practices 5

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": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124157540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 E 6TH ST STE 12",
            "city": "WESLACO",
            "state": "TX",
            "postal_code": "785966635",
            "telephone_number": "956-447-8377",
            "fax_number": "956-973-8034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 E 6TH ST STE 12",
            "city": "WESLACO",
            "state": "TX",
            "postal_code": "785966635",
            "telephone_number": "956-447-8377",
            "fax_number": "956-973-8034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weslaco, TX

Sources for this page

Verify at the official NPI Registry.