Individual provider Active NPI

Michelle Tagani, PA

  • Physician Assistant
  • Carlsbad, CA
National Provider Identifier
1366819757
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2659 State St Ste 100
Carlsbad, CA 92008-1627
Phone
(866) 938-3831
NPI assigned
Sep 1, 2015
Last updated
Jun 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NJ Primary
Physician Assistant 363A00000X PA52741 CA

Addresses

Primary practice location

2659 State St Ste 100
Carlsbad, CA 92008-1627

Mailing address

915 Carleton Rd
Westfield, NJ 07090-1689

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250529001637 NJ Practitioner - Physician Assistant 5890066047 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA52741CAMDPhysician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1441065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1366819757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 CARLETON RD",
            "city": "WESTFIELD",
            "state": "NJ",
            "postal_code": "070901689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2659 STATE ST STE 100",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920081627",
            "telephone_number": "866-938-3831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGANI",
        "first_name": "MICHELLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-01",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA52741",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, CA

Sources for this page

Verify at the official NPI Registry.