NPIMap

Individual provider Active NPI

Michele Anita Cantrell, NP

  • Nurse Practitioner
  • Burlingame, CA
National Provider Identifier
1912223389
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
21433 Issued in CA
Practice address
1501 Trousdale Dr
5TH Floor
Burlingame, CA 94010-4506
Phone
(650) 652-8787
NPI assigned
Apr 10, 2010
Last updated
Nov 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 21433 CA Primary
Registered Nurse 163W00000X 200440425RN OR
Wound Care Registered Nurse 163WW0000X 567223 CA

Addresses

Primary practice location

1501 Trousdale Dr
5TH Floor
Burlingame, CA 94010-4506

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408
Phone (650) 652-8700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20140505001222 CA Practitioner - Nurse Practitioner 3072746783 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of San MateoGroup PAC ID 9032023171, shared by 15 NPIs, 316 clinicians

Practice addresses (Care Compare)

222 W 39TH Ave
San Mateo, CA 94403-4364
Phone (650) 573-2222

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
200440425RNORMDRegistered Nurse
567223CAMDWound Care Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Mateo CurrentSince May 1, 2025 Accepting new patients
County of San Mateo CurrentSince Jul 15, 2023 Accepting new patients
County of San Mateo CurrentSince May 1, 2025 Accepting new patients
County of San Mateo CurrentSince Jul 15, 2023 Accepting new patients

Locations

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

Interoperability endpoints

  • Direct secure messaging: mcantrell190990@hisp.ehr.sutterhealth.org
  • Direct secure messaging: mcantrell19508@smch.direct-ci.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1270857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1912223389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "650-652-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 TROUSDALE DR",
            "address_2": "5TH FLOOR",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940104506",
            "telephone_number": "650-652-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTRELL",
        "first_name": "MICHELE",
        "middle_name": "ANITA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-10",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "21433",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "200440425RN",
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "CA",
            "license": "567223",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlingame, CA

Sources for this page

Verify at the official NPI Registry.