NPIMap

Individual provider Active NPI

Michelle L Caudle, PA

  • Surgical Physician Assistant
  • Springfield, MA
National Provider Identifier
1851450902
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA8877 Issued in MA
Practice address
100 Wason Ave Ste 340
Springfield, MA 01107-1179
Phone
(413) 794-8899
Fax
(413) 794-1794
NPI assigned
Dec 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA8877 MA Primary
Physician Assistant 363A00000X 003325 CT

Addresses

Primary practice location

100 Wason Ave Ste 340
Springfield, MA 01107-1179

Mailing address

280 Chestnut St FL 2
Springfield, MA 01199-1001
Phone (413) 794-5700

Other practice location 1

48 Sanderson St Fl 2
Greenfield, MA 01301-2778
Phone (413) 773-2778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160502001719 CT Practitioner - Physician Assistant 1052311941

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3325CTMDPhysical Therapist
003325CTMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Medicine Inc. Past Accepting new patients
Glendale Urgent Care LLC Past Accepting new patients
Sun City Urgent Care LLC Past Accepting new patients
Shea Urgent Care LLC Past Accepting new patients
Avondale Urgent Care LLC Past Accepting new patients
Nextcare Arizona I JV LLC Past Accepting new patients
Chandler Urgent Care LLC Past Accepting new patients
Greenway Urgent Care LLC Past Accepting new patients
Desert Ridge Urgent Care LLC Past Accepting new patients
Dana Landing Urgent Care LLC Past Accepting new patients

Organizations & group practices 10

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": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1851450902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CHESTNUT ST FL 2",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991001",
            "telephone_number": "413-794-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WASON AVE STE 340",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071179",
            "telephone_number": "413-794-8899",
            "fax_number": "413-794-1794"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "48 Sanderson St Fl 2",
            "address_purpose": "LOCATION",
            "city": "Greenfield",
            "state": "MA",
            "postal_code": "013012778",
            "country_code": "US",
            "telephone_number": "413-773-2778",
            "fax_number": "413-773-2629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAUDLE",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "PA8877",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "003325",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.