Michael Lee Bain Purviance, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A185488 Issued in CA

Practice address

975 S Fairmont Ave
Lodi, CA 95240-5118

Phone

(209) 334-3411

NPI assigned

May 27, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Internal Medicine

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Galen Inpatient Physicians PCGroup PAC ID 3678464633, 1,045 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health Lodi Memorial Hospital, Lodi, CA, CCN 050336
• St Joseph'S Medical Center of Stockton Hospital, Stockton, CA, CCN 050084

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Galen Inpatient Physicians, PC

  • Hospitalist Physician
  • Manteca, CA
  • NPI 1689320459
  Medicare reassignment Care Compare group NPD
• County of San Joaquin

  • General Acute Care Hospital
  • French Camp, CA
  • NPI 1801830583
  Medicare reassignment NPD
• San Joaquin Faculty Medical Group

  • Internal Medicine Physician
  • French Camp, CA
  • NPI 1225063761
  Medicare reassignment NPD
• County of San Joaquin

  • Multi-Specialty Clinic/Center
  • Manteca, CA
  • NPI 1417407636
  NPD
• Galen Inpatient Physicians PC

  • Hospitalist Physician
  • Los Angeles, CA
  • NPI 1205787686
  NPD
• Galen Inpatient Physicians PC

  • Internal Medicine Physician
  • Redding, CA
  • NPI 1528312758
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lodi Memorial Hospital Association Inc

  • General Acute Care Hospital
  • Lodi, CA
  • NPI 1316938301
  Care Compare affiliation
• Port City Operating Company, LLC

  • General Acute Care Hospital
  • Stockton, CA
  • NPI 1528190931
  Care Compare affiliation

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1568038933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W HOSPITAL RD",
            "city": "FRENCH CAMP",
            "state": "CA",
            "postal_code": "952319693",
            "telephone_number": "209-468-6937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 S FAIRMONT AVE",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952405118",
            "telephone_number": "209-334-3411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 W Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "French Camp",
            "state": "CA",
            "postal_code": "952319693",
            "country_code": "US",
            "telephone_number": "209-468-6937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 S Fairmont Ave",
            "address_purpose": "LOCATION",
            "city": "Lodi",
            "state": "CA",
            "postal_code": "952405148",
            "country_code": "US",
            "telephone_number": "209-333-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PURVIANCE",
        "first_name": "MICHAEL",
        "middle_name": "LEE BAIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-27",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A185488",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A185488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chandee L Pressnall, DPT
• Joseph Prinsen, D.O., PH.D.
• Pritpal Gill DDS, Inc
• Amber Leigh Pujanauski, PA-C
• Ashok Kumar Punati
• Samina Qamar, M.D.
• Robert J Quaschnick, D.D.S.
• Heather Lynn Irene Quintero, LMFT 132665
• Olha K Quintero
• Alvaro Quiroz, P.T.A.

• Internal Medicine Physician in Lodi, CA
• Providers in Lodi, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; 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.