Individual provider Active NPI

Philip Michel, PA-C

  • Physician Assistant
  • Hagerstown, MD
National Provider Identifier
1205521564
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
24 N Walnut St FL 3
Hagerstown, MD 21740-4738
Phone
(301) 687-7053
NPI assigned
Apr 11, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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 Primary

Addresses

Primary practice location

24 N Walnut St FL 3
Hagerstown, MD 21740-4738

Mailing address

10084 Reisterstown Rd Ste 300a
Owings Mills, MD 21117-4160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20241021003897 MD Practitioner - Physician Assistant 7618409202 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agape Physical Therapy and Sports Rehabilitation LPGroup PAC ID 3870741390, 684 clinicians

Practice addresses (Care Compare)

10084 Reisterstown Rd
Suite 300a
Owings Mills, MD 21117-4160
Phone (410) 521-2200

12 Newport Dr
Suite a
Forest Hill, MD 21050-1758

410 Malcolm Dr
Suite a
Westminster, MD 21157-6160
Phone (410) 876-7772

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lifebridge Community Physicians Inc CurrentSince Oct 15, 2024 Accepting new patients
Lifebridge Community Physicians, Inc CurrentSince Oct 15, 2024 Accepting new patients
Lifebridge Community Physicians, Inc Past Accepting new patients

Locations

10084 Reisterstown Rd
Ste 300A
Owings Mills, MD 21117
Phone (410) 521-2200

410 Malcolm Dr
Ste A
Westminster, MD 21157
Phone (410) 876-1633

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": "1681171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1205521564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10084 REISTERSTOWN RD STE 300A",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 N WALNUT ST FL 3",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217404738",
            "telephone_number": "301-687-7053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHEL",
        "first_name": "PHILIP",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-11",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.