Michelle J Min, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP15228 Issued in CA

Practice address

4314 W Slauson Ave
Los Angeles, CA 90043-2808

Phone

(310) 531-2000

Fax

(310) 531-2084

NPI assigned

Jun 15, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Medical InstituteGroup PAC ID 5991609737, 303 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Providence Medical Institute

  dba Providence Little Company of Mary Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1417915760
  Medicare reassignment Care Compare group NPD
• Providence Medical Institute

  dba Providence Little Company of Mary Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1235182569
  NPD
• Providence Medical Institute

  dba Providence Little Company of Mary Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1760425862
  NPD
• Axminster Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1538160098
  NPD (past)

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1508061011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11539 HAWTHORNE BLVD",
            "address_2": "STE. 6E",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902502325",
            "telephone_number": "310-531-2000",
            "fax_number": "310-531-2084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4314 W SLAUSON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900432808",
            "telephone_number": "310-531-2000",
            "fax_number": "310-531-2084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIN",
        "first_name": "MICHELLE",
        "middle_name": "J",
        "name_prefix": "Miss",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-15",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP15228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmin191867@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "12618 Hawthorne Blvd",
            "city": "Hawthorne",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902503907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jane H Min, OTD, OTR/L
• Jason J Min, PHARMD
• Jennifer Min
• John E Min, D.C.
• John K Min, MD
• Myung Ja Min, L.AC.
• Phillip Seokkee Min, D. D. S., M. S.
• Robert T Min, D.C.
• Sabin Min
• Semon M Min, D.C.

• Family Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.