Donald Wililam Micheletti, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G69692 Issued in CA

Practice address

1771 Northcrest Dr
Crescent City, CA 95531-8922

Phone

(707) 465-8666

Fax

(707) 465-6166

NPI assigned

Jul 7, 2005

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CABIAD

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.

• Crescent City Internal Medicine

  • Internal Medicine Physician
  • Crescent City, CA
  • NPI 1669468930
  NPD (past)

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209513600000",
    "number": "1275531998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1771 NORTHCREST DR",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955318922",
            "telephone_number": "707-465-8666",
            "fax_number": "707-465-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1771 NORTHCREST DR",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955318922",
            "telephone_number": "707-465-8666",
            "fax_number": "707-465-6166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHELETTI",
        "first_name": "DONALD",
        "middle_name": "WILILAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2008-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G69692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORIDIAN",
            "identifier": "100251",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G696920",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Katryn Melvin
• Juan Mendez
• Sarah Meredith, OTR/L
• Holly Amber Meyer-Zlokovich, M.S.
• Michael T. Zingg
• Roger Michelli, BA
• Martina Miller, DPT
• Theresa Mitchell
• Katherine Mize, RN
• Richard Jeffrey Mize, M.D.

• Internal Medicine Physician in Crescent City, CA
• Providers in Crescent City, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.