Active NPI
Michele Annette Stewart, M.D.
- Psychiatry Physician
- La Jolla, CA
National Provider Identifier
1568666592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- C36218
- Practice address
- 8950 Villa la Jolla Dr
Suite a-215
La Jolla, CA 92037-1714 - Phone
- (858) 457-2088
- Fax
- (858) 457-2194
- NPI assigned
- Jun 13, 2007
- Last updated
- Feb 28, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | C36218 | CA | Primary |
Addresses
Primary practice location
8950 Villa la Jolla Dr
Suite a-215
La Jolla, CA 92037-1714
Mailing address
8950 Villa la Jolla Dr
Suite a-215
La Jolla, CA 92037-1714
Phone (858) 457-2088
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C36218 | Other | CA | CALIFORNIA MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Mar 29, 2016 through Mar 29, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C36218 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456617600000",
"number": "1568666592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8950 VILLA LA JOLLA DR",
"address_2": "SUITE A-215",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920371714",
"telephone_number": "858-457-2088",
"fax_number": "858-457-2194"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8950 VILLA LA JOLLA DR",
"address_2": "SUITE A-215",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920371714",
"telephone_number": "858-457-2088",
"fax_number": "858-457-2194"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEWART",
"first_name": "MICHELE",
"middle_name": "ANNETTE",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-13",
"last_updated": "2016-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "C36218",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA MEDICAL LICENSE",
"identifier": "C36218",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in La Jolla, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2016; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.