Individual provider Active NPI

Michelle Vande Stouwe

  • Physician Assistant
  • Novato, CA
National Provider Identifier
1790561777
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA65762 Issued in CA
Practice address
165 Rowland Way Ste 208
Novato, CA 94945-5055
Phone
(415) 697-8659
Fax
(415) 817-9339
NPI assigned
Sep 5, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA65762 CA Primary

Addresses

Primary practice location

165 Rowland Way Ste 208
Novato, CA 94945-5055

Mailing address

165 Rowland Way Ste 208
Novato, CA 94945-5055
Phone (415) 697-8659

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
I20250407002580 CA Practitioner - Physician Assistant 9234653601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment
Group practices
Yoshihiro Katsuura Professional CorporationGroup PAC ID 7416313317, 2 clinicians

Practice addresses (Care Compare)

165 Rowland Way
Suite 208
Novato, CA 94945-5055
Phone (415) 697-8659

Hospital & facility affiliations

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: mvandestouwe722868@hisp.ehr.sutterhealth.org
  • Direct secure messaging: mvandestouwe3732028@oc.providencedirect.org

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.

Hospital & facility affiliations 5

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": "1693872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1790561777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 ROWLAND WAY STE 208",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949455055",
            "telephone_number": "415-697-8659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 ROWLAND WAY STE 208",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949455055",
            "telephone_number": "415-697-8659",
            "fax_number": "415-817-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDE STOUWE",
        "first_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-05",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA65762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novato, CA

Sources for this page

Verify at the official NPI Registry.