Individual provider Active NPI

Michelle Tracee-Chan Essig, M.D.

  • Pediatrics Physician
  • Los Angeles, CA
National Provider Identifier
1497016489
Registry record updated Jun 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A115298 Issued in CA
Practice address
4650 W Sunset Blvd
Mailstop 68
Los Angeles, CA 90027-6062
Phone
(323) 361-2122
Fax
(323) 361-7926
NPI assigned
Jun 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A115298 CA Primary

Addresses

Primary practice location

4650 W Sunset Blvd
Mailstop 68
Los Angeles, CA 90027-6062

Mailing address

4650 W Sunset Blvd
Mailstop 68
Los Angeles, CA 90027-6062
Phone (323) 361-2122

Other names 1

  • Dr. Michelle Tracee Chan Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160804001399 CA Practitioner - Pediatric Medicine 6305130923 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A115298CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Los Angeles Medical Group, Inc. Pediatrics CurrentSince Jun 15, 2016 Accepting new patients
Children'S Hospital Los Angeles Past Accepting new patients
Childrens Hospital of Los Angeles Past Accepting new patients

Locations

3701 Wilshire Blvd
Ste 600
Los Angeles, CA 90010
Phone (323) 361-3550

4650 W Sunset Blvd
#68
Los Angeles, CA 90027
Phone (323) 361-2122

4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122

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.

NPI Registry JSON

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338940800000",
    "number": "1497016489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD",
            "address_2": "MAILSTOP 68",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-361-2122",
            "fax_number": "323-361-7926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD",
            "address_2": "MAILSTOP 68",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-361-2122",
            "fax_number": "323-361-7926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESSIG",
        "first_name": "MICHELLE",
        "middle_name": "TRACEE-CHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-06",
        "last_updated": "2012-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A115298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "CHAN",
            "middle_name": "TRACEE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.