Individual provider Active NPI

Michelle Hartle, PA-C

  • Medical Physician Assistant
  • Kalamazoo, MI
National Provider Identifier
1477072635
Registry record updated Mar 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601008406 Issued in MI
Practice address
125 S Kalamazoo Mall Ste 204
Kalamazoo, MI 49007-4869
Phone
(269) 343-3900
NPI assigned
Sep 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601008406 MI Primary

Addresses

Primary practice location

125 S Kalamazoo Mall Ste 204
Kalamazoo, MI 49007-4869

Mailing address

5809 Sandalwood Dr
Kalamazoo, MI 49048-6634
Phone (513) 917-3910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20180109002730 MI Practitioner - Physician Assistant 1254690720 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Aug 1, 2023 Accepting new patients
Ascension Borgess Hospital CurrentSince Sep 25, 2020 Accepting new patients
Ascension Borgess Hospital CurrentSince Sep 25, 2020 Accepting new patients
Cep America LLC CurrentSince Aug 1, 2023 Accepting new patients
Bronson Methodist Hospital Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1521 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5165

411 Naomi St
Plainwell, MI 49080
Phone (269) 685-0700

4599 Towne Centre Rd
Saginaw, MI 48604
Phone (989) 497-3000

701 S Health Parkway
Three Rivers, MI 49093
Phone (269) 273-9691

Organizations & group practices 12

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": "1505779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711843200000",
    "number": "1477072635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5809 SANDALWOOD DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490486634",
            "telephone_number": "513-917-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S KALAMAZOO MALL STE 204",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490074869",
            "telephone_number": "269-343-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTLE",
        "first_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-19",
        "last_updated": "2024-03-31",
        "certification_date": "2024-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601008406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.