Individual provider Active NPI

Michelle Chin

  • Medical Physician Assistant
  • Manhattan Beach, CA
National Provider Identifier
1780112581
Registry record updated Jun 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
111 N Sepulveda Blvd Ste 210
Manhattan Beach, CA 90266
Phone
(310) 379-2134
NPI assigned
May 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

111 N Sepulveda Blvd Ste 210
Manhattan Beach, CA 90266

Mailing address

111 N Sepulveda Blvd Ste 210
Manhattan Beach, CA 90266-6849
Phone (310) 379-2134

Other practice location 1

9180 Bidwell St
Temple City, CA 91780-2454
Phone (626) 532-3349

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
I20170929001357 CA Practitioner - Physician Assistant 8820363989 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.83 of 100Reported as group
Quality
91.31
Improvement activities
40
Cost
79.05

National Provider Directory

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

Organizations & group practices 7

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": "1495584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528934400000",
    "number": "1780112581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N SEPULVEDA BLVD STE 210",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902666849",
            "telephone_number": "310-379-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N SEPULVEDA BLVD STE 210",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "90266",
            "telephone_number": "310-379-2134"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9180 Bidwell St",
            "address_purpose": "LOCATION",
            "city": "Temple City",
            "state": "CA",
            "postal_code": "917802454",
            "country_code": "US",
            "telephone_number": "626-532-3349",
            "fax_number": "626-532-3349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHIN",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-24",
        "last_updated": "2018-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhattan Beach, CA

Sources for this page

Verify at the official NPI Registry.