Individual provider Active NPI

Michelle Tricia Panlilio, MSN, RNP-BC

  • Gerontology Nurse Practitioner
  • Santa Monica, CA
National Provider Identifier
1588907893
Registry record updated Sep 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
NP 15979 Issued in CA
Practice address
1245 16TH St
#206
Santa Monica, CA 90404-1235
Phone
(310) 319-3222
Fax
(310) 319-4141
NPI assigned
Apr 4, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X NP 15979 CA Primary

Addresses

Primary practice location

1245 16TH St
#206
Santa Monica, CA 90404-1235

Mailing address

1245 16TH St
#206
Santa Monica, CA 90404-1235
Phone (310) 319-3222

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
I20130827000455 CA Practitioner - Nurse Practitioner 1850534686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Regents of the University of CaliforniaGroup PAC ID 1355248584, 1,426 clinicians

Practice addresses (Care Compare)

2020 Santa Monica Blvd
Santa Monica, CA 90404-2023
Phone (310) 458-2381

Hospital & facility affiliations

  • Sunny Days Home Care, Inc. Home health agency, Glendale, CA, CCN 757017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP 15979CAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California CurrentSince Jul 14, 2013 Accepting new patients
The Regents of the University of California CurrentSince Jul 14, 2013 Accepting new patients

Locations

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

File 55737
Los Angeles, CA 90074

1245 16th St
Ste 206
Santa Monica, CA 90404
Phone (310) 319-3222

2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381

2020 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 458-2381

Interoperability endpoints

  • Direct secure messaging: mpanlilio152749@direct.uclahealth.org

Organizations & group practices 2

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": "1365033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378425600000",
    "number": "1588907893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 16TH ST",
            "address_2": "#206",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041235",
            "telephone_number": "310-319-3222",
            "fax_number": "310-319-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 16TH ST",
            "address_2": "#206",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041235",
            "telephone_number": "310-319-3222",
            "fax_number": "310-319-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANLILIO",
        "first_name": "MICHELLE",
        "middle_name": "TRICIA",
        "credential": "MSN, RNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-04",
        "last_updated": "2013-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "NP 15979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.