Individual provider Active NPI

Michele Bernadette Cunneen, M.D.

  • Internal Medicine Physician
  • Ventura, CA
National Provider Identifier
1619986882
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G75319 Issued in CA
Practice address
3442 Loma Vista Rd
Suite C
Ventura, CA 93003-3081
Phone
(805) 642-8107
Fax
(805) 642-0964
NPI assigned
Aug 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G75319 CA Primary

Addresses

Primary practice location

3442 Loma Vista Rd
Suite C
Ventura, CA 93003-3081

Mailing address

3442 Loma Vista Rd
Suite C
Ventura, CA 93003-3081
Phone (805) 642-8107

Other identifiers 1

IdentifierTypeStateIssuer
BC3433694OtherD.E.A.

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050421000676 CA Practitioner - Internal Medicine 5092753848 Practice locations: Ventura, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G75319CAMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: mcunneen@michelecunneen.officeally.direct

NPI Registry JSON

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

{
    "created_epoch": "1154822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619986882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3442 LOMA VISTA RD",
            "address_2": "SUITE C",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033081",
            "telephone_number": "805-642-8107",
            "fax_number": "805-642-0964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3442 LOMA VISTA RD",
            "address_2": "SUITE C",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033081",
            "telephone_number": "805-642-8107",
            "fax_number": "805-642-0964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNEEN",
        "first_name": "MICHELE",
        "middle_name": "BERNADETTE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G75319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "D.E.A.",
            "identifier": "BC3433694",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.