Individual provider Active NPI

Michelle Ashley Fallon, DO

  • Emergency Medicine Physician
  • Middleburg Heights, OH
National Provider Identifier
1326401381
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
34.014417 Issued in OH
Practice address
18697 Bagley Rd
Middleburg Heights, OH 44130-3417
Phone
(440) 816-8000
NPI assigned
Mar 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 34.014417 OH Primary

Addresses

Primary practice location

18697 Bagley Rd
Middleburg Heights, OH 44130-3417

Mailing address

236 Crocker Park Blvd Apt 305
Westlake, OH 44145-8145
Phone (443) 791-1213

Other names 1

  • Michelle Boettiger Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20200710002765 OH Practitioner - Emergency Medicine 0941598742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Professional Services, Inc.Group PAC ID 7214832435, 121 clinicians

Practice addresses (Care Compare)

18697 Bagley Rd
Middlebrg HTS, OH 44130-3417
Phone (440) 816-8888

Hospital & facility affiliations

  • Southwest General Health Center Hospital, Middleburg Heights, OH, CCN 360155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Professional Services, Inc. Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients

Locations

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1326401381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 CROCKER PARK BLVD APT 305",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441458145",
            "telephone_number": "443-791-1213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18697 BAGLEY RD",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441303417",
            "telephone_number": "440-816-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLON",
        "first_name": "MICHELLE",
        "middle_name": "ASHLEY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-29",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34.014417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "BOETTIGER",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Middleburg Heights, OH

Sources for this page

Verify at the official NPI Registry.