Michelle Emily Fallis, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9109911 Issued in FL

Practice address

1700 E Venice Ave
Venice, FL 34292-3190

Phone

(941) 483-9760

Fax

(941) 483-9775

NPI assigned

Jan 28, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Global Physician Network LLC Series IIGroup PAC ID 7012282775, 67 clinicians

Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: michelle.fallis.1@4290.direct.athenahealth.com

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.

• Global Physician Network LLC Series II

  • Emergency Medicine Physician
  • Sarasota, FL
  • NPI 1821518028
  Medicare reassignment Care Compare group
• Millennium Physician Group LLC

  • Family Medicine Physician
  • Fort Myers, FL
  • NPI 1811122880
  Medicare reassignment Care Compare group
• Global Physician Network LLC Series I

  • Emergency Medicine Physician
  • Sarasota, FL
  • NPI 1316467525
  Medicare reassignment
• ENT and Allergy Associates of Florida, LLC

  • Otolaryngology Physician
  • Boca Raton, FL
  • NPI 1164473120
  NPD (past)

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

{
    "created_epoch": "1390867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1205259108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E VENICE AVE",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342923190",
            "telephone_number": "941-483-9760",
            "fax_number": "941-483-9775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLIS",
        "first_name": "MICHELLE",
        "middle_name": "EMILY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-28",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eye Doctors Optical Outlets PA
• Eye Health & Vision Center PA
• F Nicholas Gahhos MD PA
• F. Nicholas Gahhos MD PA
• Andrew Falestiny, DMD
• Family Friend Home Care LLC
• Family Spine and Pain Care Institute LLC
• Family Traditions LLC.
• Arash Farahvar, MD
• Ahmed Omer Farooq, MD

• Physician Assistant in Venice, FL
• Providers in Venice, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.