Individual provider Active NPI

Michelle Denise Pratt, N.P.F.

  • Family Nurse Practitioner
  • Long Beach, CA
National Provider Identifier
1174541171
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
402222 Issued in CA
Practice address
2840 Long Beach Blvd
Ste 365
Long Beach, CA 90806-1516
Phone
(562) 989-2374
Fax
(562) 989-2364
NPI assigned
Jul 17, 2006
Sex
Female
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
Family Nurse Practitioner 363LF0000X 402222 CA Primary

Addresses

Primary practice location

2840 Long Beach Blvd
Ste 365
Long Beach, CA 90806-1516

Mailing address

PO Box 21299
Long Beach, CA 90801-4299
Phone (562) 989-2374

Other identifiers 1

IdentifierTypeStateIssuer
402222OtherCABOARD OF NURSING LICENSE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041108000477 CA Practitioner - Nurse Practitioner 1355304601 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
402222CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Partners, a Medical Group Current Accepting new patients
Prohealth Partners, a Medical Group, Inc. CurrentSince Feb 1, 2017 Accepting new patients
Prohealth Partners a Medical Group CurrentSince Feb 1, 2017 Accepting new patients
Valerius Medical Group & Research Ctr of Greater Long Beach, Inc Past Accepting new patients

Locations

10861 Cherry St
Ste 104
Los Alamitos, CA 90720
Phone (562) 431-8771

File 54567
Los Angeles, CA 90074
Phone (310) 491-9060

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: michelle.pratt.p1@direct.valeriusmedical.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174541171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21299",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908014299",
            "telephone_number": "562-989-2374",
            "fax_number": "562-989-2364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 LONG BEACH BLVD",
            "address_2": "STE 365",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061516",
            "telephone_number": "562-989-2374",
            "fax_number": "562-989-2364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATT",
        "first_name": "MICHELLE",
        "middle_name": "DENISE",
        "name_prefix": "Ms.",
        "credential": "N.P.F.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "402222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF NURSING LICENSE",
            "identifier": "402222",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.