Individual provider Active NPI

Michelle Donato, NP

  • Gerontology Nurse Practitioner
  • Orange, CA
National Provider Identifier
1477522035
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
468117 Issued in CA
Practice address
1310 W Stewart Dr
Suite 410
Orange, CA 92868
Phone
(714) 639-9401
NPI assigned
Mar 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 468117 CA Primary

Addresses

Primary practice location

1310 W Stewart Dr
Suite 410
Orange, CA 92868

Mailing address

1310 W Stewart Dr Ste 410
Orange, CA 92868-3855

Other identifiers 4

IdentifierTypeStateIssuer
1912919804OtherNPI - TYPE 2
500012159OtherCARAIL ROAD MEDICARE - PROVIDER PTAN
CG5665OtherCARAIL ROAD MEDICARE - GROUP PTAN
W1514OtherCAMEDICARE PTAN - TYPE 2

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
I20090108000319 CA Practitioner - Nurse Practitioner 6406919026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of California, Geffen School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Feb 15, 2016 Accepting new patients
Providence Medical Foundation CurrentSince Feb 15, 2016 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Vericare of California Medical Group Past Accepting new patients
Comprehensive Pulmonary and Primary Care of Orange County Past Accepting new patients
St Jude Hospital Inc Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 400
Anaheim, CA 92805

1514 Valley Vista Dr
Diamond Bar, CA 91765
Phone (909) 560-1144

101 E Valencia Mesa Dr
Fullerton, CA 92835
Phone (714) 446-7505

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

1010 W La Veta Ave
Ste 750
Orange, CA 92868
Phone (714) 361-6600

1310 W Stewart Dr
Ste 410
Orange, CA 92868
Phone (714) 538-8549

Organizations & group practices 6

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1477522035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 W STEWART DR STE 410",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 W STEWART DR",
            "address_2": "SUITE 410",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "92868",
            "telephone_number": "714-639-9401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONATO",
        "first_name": "MICHELLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "468117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI - TYPE 2",
            "identifier": "1912919804",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE - PROVIDER PTAN",
            "identifier": "500012159",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE - GROUP PTAN",
            "identifier": "CG5665",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN - TYPE 2",
            "identifier": "W1514",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.