Michael R. Pinkston, PHD.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY4719 Issued in CA

Practice address

862 3Rd St
Santa Rosa, CA 95404-4529

Phone

(707) 575-7230

Fax

(707) 575-1513

NPI assigned

Sep 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750474086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "862 3RD ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044529",
            "telephone_number": "707-575-7230",
            "fax_number": "707-575-1513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "862 3RD ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044529",
            "telephone_number": "707-575-7230",
            "fax_number": "707-575-1513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINKSTON",
        "first_name": "MICHAEL",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "PHD.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY4719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PF0047190",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pine Flat Ranch, Inc.
• Amber Marie Pineda
• Piner-Olivet Union School District
• Patti Ann Pines
• Joseph Duane Pinkard, RADT
• Courtney Piper
• Patricia Piper, DVM
• Douglass Pipkin, RADT-
• Pisenti Chiropractic, Inc
• Patrick Francis Pisenti, D.C.

• Psychologist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.