Active NPI
Michelle Ann Piltch, AUDIOLOGIST
- Audiologist
- Petaluma, CA
National Provider Identifier
1811031479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- AU897
- Practice address
- 106 Lynch Creek Wy
Suite 9a
Petaluma, CA 94954 - Phone
- (707) 762-0103
- Fax
- (707) 762-5174
- NPI assigned
- Feb 16, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | AU897 | CA | Primary |
| Audiologist-Hearing Aid Fitter | 237600000X | HA3511 | CA |
Addresses
Primary practice location
106 Lynch Creek Wy
Suite 9a
Petaluma, CA 94954
Mailing address
1310 Commerce St
Suite B
Petaluma, CA 94954-1469
Phone (707) 778-7862
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AU 897 | Other | CA | LICENSE NO. |
| HA3511 | Other | CA | STATE OF CALIFORNIA HEARING AID LICENSING BOARD |
| HA0035110 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 897 | CA | MD | Occupational Therapy Assistant |
| AU897 | CA | MD | Audiologist |
| HA3511 | CA | MD | Audiologist-Hearing Aid Fitter |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279756800000",
"number": "1811031479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1310 COMMERCE ST",
"address_2": "SUITE B",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949541469",
"telephone_number": "707-778-7862",
"fax_number": "707-778-0969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 LYNCH CREEK WY",
"address_2": "SUITE 9A",
"city": "PETALUMA",
"state": "CA",
"postal_code": "94954",
"telephone_number": "707-762-0103",
"fax_number": "707-762-5174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PILTCH",
"first_name": "MICHELLE",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "AUDIOLOGIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-16",
"last_updated": "2010-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "CA",
"license": "AU897",
"primary": true
},
{
"code": "237600000X",
"taxonomy_group": "",
"desc": "Audiologist-Hearing Aid Fitter",
"state": "CA",
"license": "HA3511",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NO.",
"identifier": "AU 897",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF CALIFORNIA HEARING AID LICENSING BOARD",
"identifier": "HA3511",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "HA0035110",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Petaluma, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.