Immacula Michel, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ACN97 Issued in FL

Practice address

1800 Forest Hill Blvd
B-9
West Palm Beach, FL 33406-6094

Phone

(561) 968-7288

Fax

(561) 968-7488

NPI assigned

May 12, 2006

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Macomb Medical and Wellness Center PLLC

  dba Macomb Medical and Wellness C

  • Primary Care Clinic/Center
  • Warren, MI
  • NPI 1356876106
  NPD (past)

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1598716870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 FOREST HILL BLVD",
            "address_2": "B-9",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334066094",
            "telephone_number": "561-968-7288",
            "fax_number": "561-968-7488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 FOREST HILL BLVD",
            "address_2": "B-9",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334066094",
            "telephone_number": "561-968-7288",
            "fax_number": "561-968-7488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27170 Dequindre Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "MI",
            "postal_code": "480923537",
            "country_code": "US",
            "telephone_number": "248-843-5477",
            "fax_number": "586-558-8979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICHEL",
        "first_name": "IMMACULA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301112432",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ACN97",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "D EA",
            "identifier": "BM6676449",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "23888",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael S. Bess (Michael Bess DPM PA)
• Kristy Ross Michel Aldana Jr.
• Aylen Michel Gonzalez
• Aymee Michel Gonzalez
• Dieuveut Michel, PHYSICIAN ASSISTANT
• Kemeleine Michel, PTA
• Luckman Michel
• Patricia Michel
• Sharlene Michel
• Sylvia Melinda Michel, MSW

• Family Medicine Physician in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.