Individual provider Active NPI

Michelle Cristal Cardenas, NP

  • Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1548036817
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP95025110 Issued in CA
Practice address
200 UCLA Medical PLZ Ste 140
Los Angeles, CA 90095-2460
Phone
(310) 794-7700
NPI assigned
Nov 28, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95025110 CA
Nurse Practitioner 363L00000X NP95025110 CA Primary

Addresses

Primary practice location

200 UCLA Medical PLZ Ste 140
Los Angeles, CA 90095-2460

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other practice location 1

22135 Vanowen St
Canoga Park, CA 91303-2460
Phone (909) 472-9969

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240807004091 CA Practitioner - Nurse Practitioner 9537606579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Regents of the University of CaliforniaGroup PAC ID 3678545431, 47 clinicians

Practice addresses (Care Compare)

200 UCLA Medical PLZ
Suite 140
Los Angeles, CA 90095-3075
Phone (310) 825-5986

200 UCLA Medical PLZ
Suite B265
Los Angeles, CA 90095-0001
Phone (310) 825-0128

300 Stein Plaza
FL 3 Suite 331
Los Angeles, CA 90095-0001
Phone (310) 794-8492

300 Stein PLZ
FL 3
Los Angeles, CA 90095-0001
Phone (310) 794-7700

Hospital & facility affiliations

  • Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95025110CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California CurrentSince Sep 1, 2024 Accepting new patients
UCLA Urology Associates Past Accepting new patients
UCLA Medical Group Past Accepting new patients

Locations

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

300 Stein Plz
Los Angeles, CA 90095
Phone (310) 794-8492

200 Medical Plz
Ste 140
Los Angeles, CA 90095
Phone (310) 206-1434

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

200 UCLA Medical Plz
Ste 140
Los Angeles, CA 90095
Phone (310) 206-8164

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 1

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": "1701129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1548036817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 UCLA MEDICAL PLZ STE 140",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900952460",
            "telephone_number": "310-794-7700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22135 Vanowen St",
            "address_purpose": "LOCATION",
            "city": "Canoga Park",
            "state": "CA",
            "postal_code": "913032460",
            "country_code": "US",
            "telephone_number": "909-472-9969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARDENAS",
        "first_name": "MICHELLE",
        "middle_name": "CRISTAL",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-28",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95025110",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95025110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.