Individual provider Active NPI

Michelle Marie Paulsen, D.O.

  • Family Medicine Physician
  • Chesapeake, VA
National Provider Identifier
1689876823
Registry record updated Jun 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0102201919 Issued in VA
Practice address
516 Innovation Dr
Suite 103
Chesapeake, VA 23320-3847
Phone
(757) 495-0606
NPI assigned
Jun 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0102201919 VA Primary

Addresses

Primary practice location

516 Innovation Dr
Suite 103
Chesapeake, VA 23320-3847

Mailing address

609 Centerville Tpke S
Chesapeake, VA 23322-3913
Phone (757) 621-6424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20080808000641 VA Practitioner - Family Practice 4789758764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tidewater Family Medical Care, PCGroup PAC ID 9436103306, 2 clinicians

Practice addresses (Care Compare)

516 Innovation Dr
Chesapeake, VA 23320-3866
Phone (757) 495-0606

Hospital & facility affiliations

  • Sentara Leigh Hospital Hospital, Norfolk, VA, CCN 490046
  • Chesapeake General Hospital Hospital, Chesapeake, VA, CCN 490120
  • Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007
  • Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119
  • Sentara Virginia Beach General Hospital Hospital, Virginia Beach, VA, CCN 490057

Merit-based Incentive Payment System (MIPS)

Final score
85.24 of 100Reported as group
Quality
77.98
Improvement activities
40
Cost
80.17

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102201919VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Family Medical Care, PC Family Medicine CurrentSince Aug 1, 2008 Accepting new patients

Locations

516 Innovation Dr
Ste 103
Chesapeake, VA 23320
Phone (703) 978-0050

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.

Hospital & facility affiliations 8

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": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277337600000",
    "number": "1689876823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 CENTERVILLE TPKE S",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233223913",
            "telephone_number": "757-621-6424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 INNOVATION DR",
            "address_2": "SUITE 103",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233203847",
            "telephone_number": "757-495-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULSEN",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-01",
        "last_updated": "2010-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102201919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.