Robert Edward Michelin, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

C36138 Issued in CA

Practice address

155 Glasson Way
Grass Valley, CA 95945-5723

Phone

(530) 274-6000

NPI assigned

Jan 4, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Faye Jensen M.D., Inc.

  • Obstetrics & Gynecology Physician
  • Grass Valley, CA
  • NPI 1417594078
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1154478055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2414",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959452414",
            "telephone_number": "530-273-1914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 GLASSON WAY",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455723",
            "telephone_number": "530-274-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHELIN",
        "first_name": "ROBERT",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "C36138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00361380",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul Johnathan Meyer, MFT
• Micah Berry M D Inc a Professional Corporation
• Michael G Dahle MD,a Professional Corporation
• Michael Phillips Rice LMFT
• Sarah Michalak, RRW
• Michelle Kucera, DDS, Inc.
• Cynthia Middaugh, CADC-II
• Diane Miessler
• Mariya Milan, LMFT
• Shayne Millard

• Surgery Physician in Grass Valley, CA
• Providers in Grass Valley, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.