Michael David Fox, MD

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

G31552 Issued in CA

Practice address

15 Escalon Dr
Mill Valley, CA 94941-1339

Phone

(415) 515-7773

Fax

(415) 388-2829

NPI assigned

Oct 18, 2005

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 2

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.

• Village Health Services, LLC

  • Physical Therapist
  • San Rafael, CA
  • NPI 1730680810
  NPD (past)

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442793600000",
    "number": "1225027709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 ESCALON DR",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949411339",
            "telephone_number": "415-515-7773",
            "fax_number": "415-388-2829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 ESCALON DR",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949411339",
            "telephone_number": "415-515-7773",
            "fax_number": "415-388-2829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2015-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "G31552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G315520",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G315520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laravic Trance Flores, M.D.
• Tracy Elizabeth Foose, M.D.
• Denise Genevieve Santos Ford, CCC - SLP
• Patrick Ford, LMFT
• Emily Fortner
• Tiffany Franco, DPT
• Karena Franses, LCSW
• Gerald C. Freedman, M.D.
• Conde C Freeman, LAC
• Freund Chiropractic Corporation

• Geriatric Medicine (Family Medicine) Physician in Mill Valley, CA
• Providers in Mill Valley, CA by specialty
• Geriatric Medicine (Family Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; 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.