Individual provider Active NPI

Michael Holsten, MSW, LCSW

  • Physician Assistant
  • Raleigh, NC
National Provider Identifier
1700294899
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
6112 Saint Giles St
Raleigh, NC 27612-7043
Phone
(919) 893-4465
NPI assigned
Aug 1, 2014
Last updated
Dec 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C010308 NC
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

6112 Saint Giles St
Raleigh, NC 27612-7043

Mailing address

6112 Saint Giles St
Raleigh, NC 27612-7043
Phone (919) 893-4465

Other practice location 1

6112 Saint Giles St
Raleigh, NC 27612-7043
Phone (919) 893-4465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20240614000152 NC Practitioner - Physician Assistant 7618257494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of North Carolina at Chapel Hill School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advaita Integrated Medicine PLLCGroup PAC ID 4385023043, 17 clinicians

Practice addresses (Care Compare)

6112 Saint Giles St
Raleigh, NC 27612-7043
Phone (919) 893-4465

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Green Hill Recovery, LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1406851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1700294899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6112 SAINT GILES ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276127043",
            "telephone_number": "919-893-4465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6112 SAINT GILES ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276127043",
            "telephone_number": "919-893-4465"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6112 Saint Giles St",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276127043",
            "country_code": "US",
            "telephone_number": "919-893-4465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLSTEN",
        "first_name": "MICHAEL",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-01",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C010308",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.