Individual provider Active NPI

Michael Plessas, P.A.

  • Physician Assistant
  • Modesto, CA
National Provider Identifier
1407919699
Registry record updated Jan 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA14097 Issued in CA
Practice address
1441 Florida Ave
Modesto, CA 95350-4405
Phone
(209) 576-3971
NPI assigned
Dec 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA14097 CA Primary

Addresses

Primary practice location

1441 Florida Ave
Modesto, CA 95350-4405

Mailing address

PO Box 10394
Truckee, CA 96162-0394
Phone (916) 837-0478

Other identifiers 1

IdentifierTypeStateIssuer
CD069AOtherCAGROUP PTAN

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
I20040413000906 CA Practitioner - Physician Assistant 9830183797 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
517NVMDAdult Medicine Physician
PA14097CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Plumas Health Care Home Health CurrentSince Feb 20, 2024 Accepting new patients
Eastern Plumas Health Care District CurrentSince Feb 20, 2024 Accepting new patients
Eastern Plumas Health Care District CurrentSince Dec 5, 2025 Accepting new patients
California Em-I Medical Services, a Medical Corporation Physician Assistant Past Accepting new patients

Locations

500 1st Ave
Portola, CA 96122
Phone (530) 832-4277

480 1st Ave
Portola, CA 96122
Phone (530) 832-6600

Organizations & group practices 10

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 2

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

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Plumas Health Care District 31 clinicians

Practice addresses (Care Compare)

480 1St Ave
Portola, CA 96122-9405
Phone (530) 832-6600

Hospital & facility affiliations

  • Eastern Plumas Hospital - Portola Campus Hospital, Portola, CA, CCN 051300

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327449600000",
    "number": "1407919699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10394",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961620394",
            "telephone_number": "916-837-0478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 FLORIDA AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504405",
            "telephone_number": "209-576-3971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLESSAS",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2012-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA14097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "CD069A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.