Individual provider Active NPI

Mischelle Bernice Turner, PA-C

  • Medical Physician Assistant
  • Pasadena, CA
National Provider Identifier
1700096468
Registry record updated Apr 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA14175 Issued in CA
Practice address
1800 N Lake Ave
Pasadena, CA 91104-1228
Phone
(626) 993-1238
Fax
(626) 993-1288
NPI assigned
May 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA14175 CA
Medical Physician Assistant 363AM0700X PA14175 CA Primary

Addresses

Primary practice location

1800 N Lake Ave
Pasadena, CA 91104-1228

Mailing address

1743 W 149TH St Unit D
Gardena, CA 90247-2874
Phone (310) 715-6990

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
I20110225000707 CA Practitioner - Physician Assistant 2860673696 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA14175CAMDMedical Physician Assistant

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.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397692800000",
    "number": "1700096468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1743 W 149TH ST UNIT D",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902472874",
            "telephone_number": "310-715-6990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 N LAKE AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911041228",
            "telephone_number": "626-993-1238",
            "fax_number": "626-993-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TURNER",
        "first_name": "MISCHELLE",
        "middle_name": "BERNICE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2014-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA14175",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA14175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.