Individual provider Active NPI

Michael Robert Dionne, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Concord, CA
National Provider Identifier
1336035666
Registry record updated Apr 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95038262 Issued in CA
Practice address
1800 Sutter St Ste 500
Concord, CA 94520-2587
Phone
(707) 469-3402
NPI assigned
Jun 13, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 116023-23 NH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209034132 IL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 407280 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 8371598 ID
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95038262 CA Primary

Addresses

Primary practice location

1800 Sutter St Ste 500
Concord, CA 94520-2587

Mailing address

30 N Gould St Ste R
Sheridan, WY 82801-6317
Phone (707) 469-3402

Other practice location 1

800 W Main St Ste 1460
Boise, ID 83702-5983
Phone (707) 469-3402

Other practice location 2

186 Dunbarton Rd Apt 3
Manchester, NH 03102-6522
Phone (707) 469-3402

Other practice location 3

2 Pine West Plz Ste 205
Albany, NY 12205-5532
Phone (707) 469-3402

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260616000504 CA Practitioner - Nurse Practitioner 3779055314 Practice locations: Concord, CA

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Concord, CA 94521
Phone (707) 470-9264

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95038262CAMDPsychiatric/Mental Health Nurse Practitioner
8371598IDMDPsychiatric/Mental Health Nurse Practitioner
209034132ILMDPsychiatric/Mental Health Nurse Practitioner
116023-23NHMDPsychiatric/Mental Health Nurse Practitioner
407280NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Reforge Psychiatry LLC Psychiatric/Mental Health CurrentSince Jun 15, 2025 Accepting new patients

Locations

1800 Sutter St
Ste 500
Concord, CA 94520
Phone (707) 469-3402

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.

NPI Registry JSON

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

{
    "created_epoch": "1749772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775347200000",
    "number": "1336035666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N GOULD ST STE R",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828016317",
            "telephone_number": "707-469-3402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 SUTTER ST STE 500",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202587",
            "telephone_number": "707-469-3402"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 W Main St Ste 1460",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837025983",
            "country_code": "US",
            "telephone_number": "707-469-3402",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "186 Dunbarton Rd Apt 3",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "NH",
            "postal_code": "031026522",
            "country_code": "US",
            "telephone_number": "707-469-3402",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Pine West Plz Ste 205",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122055532",
            "country_code": "US",
            "telephone_number": "707-469-3402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIONNE",
        "first_name": "MICHAEL",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-13",
        "last_updated": "2026-04-05",
        "certification_date": "2026-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NH",
            "license": "116023-23",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209034132",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "407280",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "8371598",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95038262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

Verify at the official NPI Registry.