Individual provider Active NPI

Mechele Fillman, NP

  • Gerontology Nurse Practitioner
  • Palo Alto, CA
National Provider Identifier
1699033993
Registry record updated Sep 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
21783 Issued in CA
Practice address
300 Pasteur Dr
Palo Alto, CA 94305-2200
Phone
(650) 723-4000
NPI assigned
Apr 25, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 21783 CA Primary

Addresses

Primary practice location

300 Pasteur Dr
Palo Alto, CA 94305-2200

Mailing address

1804 Embarcadero Rd
Ste 100
Palo Alto, CA 94303-3341
Phone (650) 723-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20180621002059 NM Practitioner - Nurse Practitioner 5890951982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent HospitalGroup PAC ID 6608775135, 335 clinicians

Practice addresses (Care Compare)

1631 Hospital Dr
Suite 100
Santa Fe, NM 87505-7631
Phone (505) 982-7246

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
21783CAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Hospital CurrentSince Oct 1, 2019 Accepting new patients
St Vincent Hospital Current Accepting new patients
St Vincent Hospital Current Accepting new patients
St. Vincent Hospital CurrentSince Oct 1, 2019 Accepting new patients

Locations

1631 Hospital Dr
Ste 100
Santa Fe, NM 87505
Phone (505) 955-8420

455 Saint Michaels Dr
Santa Fe, NM 87505
Phone (505) 913-3361

465 Saint Michaels Dr
Ste 200
Santa Fe, NM 87505
Phone (505) 995-4901

465 Saint Michaels Dr
Ste 200
Santa Fe, NM 87505
Phone (505) 995-4901

1631 Hospital Dr
Ste 240
Santa Fe, NM 87505
Phone (505) 913-3975

1631 Hospital Dr
Ste 100A
Santa Fe, NM 87505
Phone (505) 982-7246

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.

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": "1335312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475193600000",
    "number": "1699033993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 EMBARCADERO RD",
            "address_2": "STE 100",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943033341",
            "telephone_number": "650-723-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FILLMAN",
        "first_name": "MECHELE",
        "name_prefix": "Miss",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-25",
        "last_updated": "2016-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "21783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.