Michelle Josette Edwards, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA64163 Issued in CA

Practice address

40910 Fremont Blvd
Fremont, CA 94538-4375

Phone

(510) 252-6862

NPI assigned

Sep 19, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bay Area Community HealthGroup PAC ID 1658349824, 106 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Bay Area Community Health

  dba BACH School Mobile Health Clinic II

  • Federally Qualified Health Center (FQHC)
  • Fremont, CA
  • NPI 1780054379
  Medicare reassignment Care Compare group NPD
• Bay Area Community Health

  dba Bay Area Community Health - Hope Project

  • Federally Qualified Health Center (FQHC)
  • Fremont, CA
  • NPI 1942387188
  NPD (past)

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

{
    "created_epoch": "1505779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1427577642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1142 MADERA AVE",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940251604",
            "telephone_number": "832-226-3759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40910 FREMONT BLVD",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945384375",
            "telephone_number": "510-252-6862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "MICHELLE",
        "middle_name": "JOSETTE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-19",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA64163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edmundo Ruiz Davila, M.D.,Inc.
• Joshua Delfin Ednalino
• Shirley Maria Edward, M.D.
• Gregory William Edwards, RN
• Justin Edwards
• Edwin Chicchon DDS Inc (Sonrisas Bright Dental)
• Thomas Irwin Efird, M.D.
• Bogdan Silviu Eftimie, M.D.
• Eldan B Eichbaum, MD
• Christine Eicher Raymond, FNP-BC, MSN, RN, OCN

• Physician Assistant in Fremont, CA
• Providers in Fremont, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.