Individual provider Active NPI

Michelle Angela Fajardo, D.O.

  • Anatomic Pathology & Clinical Pathology Physician
  • Laguna Hills, CA
National Provider Identifier
1639381387
Registry record updated Jan 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
20A9558 Issued in CA
Practice address
24451 Health Center Dr
Laguna Hills, CA 92653-3689
Phone
(949) 452-3053
Fax
(949) 452-3066
NPI assigned
May 4, 2007
Last updated
Jan 27, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 20A9558 CA Primary

Addresses

Primary practice location

24451 Health Center Dr
Laguna Hills, CA 92653-3689

Mailing address

2374 E Pacifica PL
Rancho Dominguez, CA 90220-6214
Phone (310) 225-3244

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
I20090812000801 CA Practitioner - Pathology 1850445628 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Affiliated Pathologists Medical Group, Inc.Group PAC ID 7315840535, 46 clinicians

Practice addresses (Care Compare)

24451 Health Ctr Dr
Laguna Hills, CA 92653-3689
Phone (310) 225-3244

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.39 of 100Reported as group
Quality
88.62
Improvement activities
40
Cost
77.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A9558CAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Affiliated Pathologists Medical Group, Inc. Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2009 Accepting new patients
Pih Health Good Samaritan Hospital Past Accepting new patients
Soc Pathology Medical Group Inc. Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

24451 Health Center Dr
Laguna Hills, CA 92653
Phone (949) 452-3573

1680 E 120th St
Los Angeles, CA 90059
Phone (424) 338-8000

2374 E Pacifica Pl
Rancho Dominguez, CA 90220
Phone (310) 225-3221

654 Camino de los Mares
San Clemente, CA 92673
Phone (949) 489-4507

1300 W 7th St
San Pedro, CA 90732
Phone (310) 514-5350

19951 Mariner Ave
Ste 155
Torrance, CA 90503
Phone (310) 225-3221

Organizations & group practices 3

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.

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": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453852800000",
    "number": "1639381387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2374 E PACIFICA PL",
            "city": "RANCHO DOMINGUEZ",
            "state": "CA",
            "postal_code": "902206214",
            "telephone_number": "310-225-3244",
            "fax_number": "310-698-7054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24451 HEALTH CENTER DR",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533689",
            "telephone_number": "949-452-3053",
            "fax_number": "949-452-3066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAJARDO",
        "first_name": "MICHELLE",
        "middle_name": "ANGELA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2016-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "20A9558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

Verify at the official NPI Registry.