Individual provider Active NPI

Marc Andrew Michelsen, DO

  • Anesthesiology Physician
  • Richmond, VA
National Provider Identifier
1487862173
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
OS10131 Issued in FL
Practice address
1250 E Marshall St
Richmond, VA 23298-5051
Phone
(804) 828-9783
NPI assigned
May 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 0102201626 VA
Anesthesiology Physician 207L00000X OS10131 FL Primary

Addresses

Primary practice location

1250 E Marshall St
Richmond, VA 23298-5051

Mailing address

PO Box 980257
Richmond, VA 23298-0257
Phone (804) 828-9783

Other identifiers 4

IdentifierTypeStateIssuer
2795671 00MedicaidFL
17310OtherFLBCBSFL
7328195OtherFLCIGNA
7983907OtherFLAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071127000205 FL Practitioner - Anesthesiology 8820186992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
US Anesthesia Partners of Florida IncGroup PAC ID 0345143152, 1,111 clinicians

Practice addresses (Care Compare)

2776 Cleveland Ave
Fort Myers, FL 33901-5864
Phone (239) 343-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.8 of 100Reported as group
Quality
99.47
Improvement activities
40
Cost
83.62

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS10131FLMDAnesthesiology Physician
0102201626VAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
US Anesthesia Partners of Florida Inc. Anesthesiology CurrentSince Mar 25, 2015 Accepting new patients
Piedmont Healthcare, P.a. Past Accepting new patients
Jennifer Sassi PA PastSince Feb 5, 2014 Accepting new patients

Locations

636 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 332-5344

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

851 Trafalgar Ct
Ste 200E
Maitland, FL 32751
Phone (321) 422-7155

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

Organizations & group practices 3

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1487862173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 980257",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232980257",
            "telephone_number": "804-828-9783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E MARSHALL ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232985051",
            "telephone_number": "804-828-9783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHELSEN",
        "first_name": "MARC",
        "middle_name": "ANDREW",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0102201626",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "OS10131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2795671 00",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "17310",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7328195",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7983907",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.