Individual provider Active NPI

Michelle Lise Daley, PA-C

  • Medical Physician Assistant
  • Oceanside, CA
National Provider Identifier
1659631208
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0110003843 Issued in VA
Practice address
3910 Vista Way Ste 106
Oceanside, CA 92056-4513
Phone
(760) 941-2000
NPI assigned
May 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0110003843 VA Primary
Surgical Physician Assistant 363AS0400X C0004733 MD
Physician Assistant 363A00000X PA66482 CA

Addresses

Primary practice location

3910 Vista Way Ste 106
Oceanside, CA 92056-4513

Mailing address

414 Shadow Tree Dr
Oceanside, CA 92058-7023

Other names 1

  • Mrs. Michelle Lise Levesque Former name

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
I20260424001254 CA Practitioner - Physician Assistant 9638328834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5080 Spectrum Dr
Suite 1200W
Addison, TX 75001-6443

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA66482CAMDPhysician Assistant
C0004733MDMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Aug 1, 2015 Accepting new patients
Union Memorial Hospital Past Accepting new patients
National Rehabilitation Hospital, Inc. Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

3333 N Calvert St
Ste 200
Baltimore, MD 21218
Phone (202) 877-1120

201 E University Pkwy
Baltimore, MD 21218
Phone (410) 554-2651

1406 Crain Hwy S
Glen Burnie, MD 21061
Phone (410) 768-6440

1407 York Rd
Ste 100A
Lutherville Timonium, MD 21093
Phone (410) 252-9090

412 Malcolm Dr
Ste 200
Westminster, MD 21157
Phone (410) 751-7930

Organizations & group practices 5

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": "1337126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1659631208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 SHADOW TREE DR",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920587023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 VISTA WAY STE 106",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564513",
            "telephone_number": "760-941-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALEY",
        "first_name": "MICHELLE",
        "middle_name": "LISE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-16",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110003843",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C0004733",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA66482",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "LEVESQUE",
            "middle_name": "LISE",
            "prefix": "MRS.",
            "credential": "LEVESQUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oceanside, CA

Sources for this page

Verify at the official NPI Registry.