Individual provider Active NPI

Michael Pavan, D.C.

  • Chiropractor
  • Newhall, CA
National Provider Identifier
1639313653
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC31242 Issued in CA
Practice address
24509 Walnut St Ste 101
Newhall, CA 91321-2846
Phone
(661) 776-4500
Fax
(661) 253-9601
NPI assigned
Apr 21, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X DC31242 CA
Chiropractor 111N00000X DC31242 CA Primary

Addresses

Primary practice location

24509 Walnut St Ste 101
Newhall, CA 91321-2846

Mailing address

24509 Walnut St Ste 101
Newhall, CA 91321-2846
Phone (661) 776-4500

Other identifiers 1

IdentifierTypeStateIssuer
DC31242,OtherCALICENCE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250709000177 CA Practitioner - Chiropractic 7113431552 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Los Angeles, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

24509 Walnut St
Suite 101
Newhall, CA 91321-2846
Phone (661) 776-4500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC31242CAMDRehabilitation Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Chiropractic SCV Pavan Inc Chiropractor CurrentSince May 7, 2025 Accepting new patients

Locations

24509 Walnut St
Ste 101
Newhall, CA 91321
Phone (661) 253-9600

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1240272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1639313653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24509 WALNUT ST STE 101",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "913212846",
            "telephone_number": "661-776-4500",
            "fax_number": "661-253-9601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24509 WALNUT ST STE 101",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "913212846",
            "telephone_number": "661-776-4500",
            "fax_number": "661-253-9601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVAN",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-21",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "CA",
            "license": "DC31242",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC31242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCE NUMBER",
            "identifier": "DC31242,",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newhall, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.