Michelle Lynn Storandt, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

M0579 Issued in TX

Practice address

20642 Stone Oak Pkwy
Suite 105
San Antonio, TX 78258-7362

Phone

(210) 479-3000

Fax

(210) 479-3016

NPI assigned

Jun 9, 2006

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

Other identifiers 4

Other names 1

• Michelle Lynn Moore Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Acorn Pediatrics of San Antonio

  • Pediatrics Physician
  • San Antonio, TX
  • NPI 1619265220
  NPD (past)

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331251200000",
    "number": "1528009776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20642 STONE OAK PKWY",
            "address_2": "SUITE 105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782587362",
            "telephone_number": "210-479-3000",
            "fax_number": "210-479-3016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20642 STONE OAK PKWY",
            "address_2": "SUITE 105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782587362",
            "telephone_number": "210-479-3000",
            "fax_number": "210-479-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORANDT",
        "first_name": "MICHELLE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2012-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "M0579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1265475891",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "169952201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID-GROUP EPSDT",
            "identifier": "173321402",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID-GOUP TPI",
            "identifier": "173321401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "MOORE",
            "middle_name": "LYNN",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Stop the Cycle Education
• Alyssa Cassandra Storb
• Silviana Storgion
• Caitlin Feller Stork, FNP
• Kaylyn Stork
• Isabella Storlid, IONM

• Pediatrics Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.