Individual provider Active NPI

Michael Harold Bishop, D.O.

  • Emergency Medicine Physician
  • Brawley, CA
National Provider Identifier
1497865364
Registry record updated Aug 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20A5759 Issued in CA
Practice address
207 W Legion Rd
Brawley, CA 92227-7780
Phone
(760) 351-3333
NPI assigned
Aug 30, 2006
Last updated
Aug 31, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 20A5759 CA Primary

Addresses

Primary practice location

207 W Legion Rd
Brawley, CA 92227-7780

Mailing address

2100 Powell St
Suite 900
Emeryville, CA 94608-1826
Phone (510) 350-2600

Other identifiers 1

IdentifierTypeStateIssuer
00AX57590MedicaidCA

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080122000471 CA Practitioner - Undersea and Hyperbaric MedicinePractitioner - Emergency Medicine 0749361244 Reassigns benefits to 1 organization
Practice locations: Brawley, CA; Redlands, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A5759CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine CurrentSince Dec 15, 2000 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America-California Emergency Medicine CurrentSince Dec 15, 2000 Accepting new patients

Locations

600 N Highland Springs Ave
Banning, CA 92220
Phone (833) 443-6287

207 W Legion Rd
Brawley, CA 92227
Phone (760) 351-3333

751 Medical Center Ct
#1182
Chula Vista, CA 91911

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

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

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188518400000",
    "number": "1497865364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "SUITE 900",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 W LEGION RD",
            "city": "BRAWLEY",
            "state": "CA",
            "postal_code": "922277780",
            "telephone_number": "760-351-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISHOP",
        "first_name": "MICHAEL",
        "middle_name": "HAROLD",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A5759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX57590",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brawley, CA

Sources for this page

Verify at the official NPI Registry.