Active NPI
Michele Missakian, PA-C
- Physician Assistant
- Huntington Beach, CA
National Provider Identifier
1215254461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 19690
- Practice address
- 19671 Beach Blvd Ste 215
Huntington Beach, CA 92648-5903 - Phone
- (714) 545-5550
- NPI assigned
- Apr 28, 2010
- Last updated
- Oct 4, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 19690 | CA | Primary |
Addresses
Primary practice location
19671 Beach Blvd Ste 215
Huntington Beach, CA 92648-5903
Mailing address
2100 Powell St
920
Emeryville, CA 94608-1826
Phone (888) 267-3880
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19690 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728000000000",
"number": "1215254461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 POWELL ST",
"address_2": "920",
"city": "EMERYVILLE",
"state": "CA",
"postal_code": "946081826",
"telephone_number": "888-267-3880",
"fax_number": "510-879-9100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19671 BEACH BLVD STE 215",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926485903",
"telephone_number": "714-545-5550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MISSAKIAN",
"first_name": "MICHELE",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-28",
"last_updated": "2024-10-04",
"certification_date": "2024-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "19690",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; 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.