Individual provider Active NPI

Michelle M Cohen, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Washington, PA
National Provider Identifier
1124497995
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP023180 Issued in PA
Practice address
37 Highland Ave
Washington, PA 15301-4062
Phone
(724) 223-1067
Fax
(724) 223-1088
NPI assigned
Sep 22, 2015
Last updated
Jul 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP015236 PA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP023180 PA Primary

Addresses

Primary practice location

37 Highland Ave
Washington, PA 15301-4062

Mailing address

1070 Old National Pike
Fredericktown, PA 15333-2114
Phone (724) 632-6801

Other practice location 1

190 Bonar Ave
Waynesburg, PA 15370-1604
Phone (724) 627-8156

Other identifiers 2

IdentifierTypeStateIssuer
1007288440104MedicaidPA
014582OtherPAHIGHMARK BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20151118002232 PA Practitioner - Nurse Practitioner 6103126453 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centerville Clinics, Inc.Group PAC ID 7214837202, 44 clinicians

Practice addresses (Care Compare)

190 Bonar Ave
Waynesburg, PA 15370-1604
Phone (724) 627-8156

37 Highland Ave
Washington, PA 15301-4062
Phone (724) 223-1067

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP023180PAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centerville Clinics, Inc. Current Accepting new patients
Centerville Clinics, Inc CurrentSince Oct 5, 2015 Accepting new patients
Centerville Clinics, Inc. CurrentSince Oct 5, 2015 Accepting new patients
Centerville Clinics, Inc. Current Accepting new patients
Centerville Clinics, Inc. Current Accepting new patients
Centerville Clinics, Inc. Current Accepting new patients
Centerville Clinics, Inc, Past Accepting new patients

Locations

1070 Old National Pike
Fredericktown, PA 15333

37 Highland Ave
Washington, PA 15301
Phone (724) 223-1067

190 Bonar Ave
Waynesburg, PA 15370
Phone (724) 627-8156

Interoperability endpoints

  • Direct secure messaging: michelle.cohen.1@33484.direct.athenahealth.com

Organizations & group practices 7

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.

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": "1442880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1124497995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 OLD NATIONAL PIKE",
            "city": "FREDERICKTOWN",
            "state": "PA",
            "postal_code": "153332114",
            "telephone_number": "724-632-6801",
            "fax_number": "724-632-6312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 HIGHLAND AVE",
            "city": "WASHINGTON",
            "state": "PA",
            "postal_code": "153014062",
            "telephone_number": "724-223-1067",
            "fax_number": "724-223-1088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "190 Bonar Ave",
            "address_purpose": "LOCATION",
            "city": "Waynesburg",
            "state": "PA",
            "postal_code": "153701604",
            "country_code": "US",
            "telephone_number": "724-627-8156",
            "fax_number": "724-852-1412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COHEN",
        "first_name": "MICHELLE",
        "middle_name": "M",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-22",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP015236",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP023180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007288440104",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "014582",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, PA

Sources for this page

Verify at the official NPI Registry.