Individual provider Active NPI

Michelle Lynn Staley, PA-C

  • Physician Assistant
  • Wexford, PA
National Provider Identifier
1417370487
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
7000 Stonewood Dr Ste 300
Wexford, PA 15090-8326
Phone
(724) 242-8671
Fax
(724) 242-8672
NPI assigned
Jan 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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 Primary

Addresses

Primary practice location

7000 Stonewood Dr Ste 300
Wexford, PA 15090-8326

Mailing address

7000 Stonewood Dr Ste 300
Wexford, PA 15090-8326
Phone (724) 242-8671

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20190108001759 PA Practitioner - Physician Assistant 4183842974 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New Directions Mental Health, PCGroup PAC ID 0345228318, 153 clinicians

Practice addresses (Care Compare)

110 Hidden Valley Rd
MC Murray, PA 15317-2685
Phone (724) 374-3468

117 Vip Dr
Suite 310
Wexford, PA 15090-6936
Phone (724) 374-3468

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Intercare Health Systems, LTD, Dba Intercare Psychiatric Services Past Accepting new patients
Ravi Kant, MD PC PastSince Feb 1, 2025 Accepting new patients

Organizations & group practices 4

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": "1390867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1417370487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 STONEWOOD DR STE 300",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150908326",
            "telephone_number": "724-242-8671",
            "fax_number": "724-242-8672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 STONEWOOD DR STE 300",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150908326",
            "telephone_number": "724-242-8671",
            "fax_number": "724-242-8672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALEY",
        "first_name": "MICHELLE",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-28",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wexford, PA

Sources for this page

Verify at the official NPI Registry.