Individual provider Active NPI

Maria Z Michnowska, M.D.

  • Internal Medicine Physician
  • San Andreas, CA
National Provider Identifier
1336261106
Registry record updated Apr 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A73232 Issued in CA
Practice address
704 Mountain Ranch Rd
Suite 103
San Andreas, CA 95249-0000
Phone
(209) 754-4564
NPI assigned
Apr 4, 2007
Last updated
Apr 29, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A73232 CA Primary

Addresses

Primary practice location

704 Mountain Ranch Rd
Suite 103
San Andreas, CA 95249-0000

Mailing address

610 Anrey CT
Murphys, CA 95247-9385
Phone (209) 754-4564

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040220001181 CA Practitioner - Internal Medicine 9436044021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Team Acute Care CorporationGroup PAC ID 4587002290, 11 clinicians

Practice addresses (Care Compare)

768 Mountain Ranch Rd
San Andreas, CA 95249-9707
Phone (209) 464-6422

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Team Acute Care Corporation CurrentSince Apr 1, 2024 Accepting new patients
Motion Picture and Television Fund Medical Group, Inc Internal Medicine Past Accepting new patients

Locations

768 Mountain Ranch Rd
San Andreas, CA 95249
Phone (209) 464-6422

1801 E March Ln
Ste C300
Stockton, CA 95210
Phone (209) 464-6422

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272499200000",
    "number": "1336261106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 ANREY CT",
            "city": "MURPHYS",
            "state": "CA",
            "postal_code": "952479385",
            "telephone_number": "209-754-4564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 MOUNTAIN RANCH RD",
            "address_2": "SUITE 103",
            "city": "SAN ANDREAS",
            "state": "CA",
            "postal_code": "952490000",
            "telephone_number": "209-754-4564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHNOWSKA",
        "first_name": "MARIA",
        "middle_name": "Z",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2010-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A73232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Andreas, CA

Sources for this page

Verify at the official NPI Registry.