Individual provider Active NPI

Michelle Anne Fishman, PA-C

  • Physician Assistant
  • Oxnard, CA
National Provider Identifier
1689838609
Registry record updated Jul 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 18469 Issued in CA
Practice address
2241 Wankel Way Ste B
Oxnard, CA 93030-0191
Phone
(805) 983-0425
Fax
(805) 983-0414
NPI assigned
Jul 18, 2008
Last updated
Jul 18, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 18469 CA Primary

Addresses

Primary practice location

2241 Wankel Way Ste B
Oxnard, CA 93030-0191

Mailing address

2241 Wankel Way Ste B
Oxnard, CA 93030-0191
Phone (805) 983-0425

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
I20130507000597 CA Order and Referring Only - Physician Assistant 7012154222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA 18469CAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1216339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216339200000",
    "number": "1689838609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2241 WANKEL WAY STE B",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930300191",
            "telephone_number": "805-983-0425",
            "fax_number": "805-983-0414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2241 WANKEL WAY STE B",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930300191",
            "telephone_number": "805-983-0425",
            "fax_number": "805-983-0414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHMAN",
        "first_name": "MICHELLE",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-18",
        "last_updated": "2008-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 18469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

Verify at the official NPI Registry.