Michelle M Bowen, PA-C
Individual provider Active NPI Medical Physician Assistant · Macomb, IL
NPI 1952539975 · NPPES record last updated Feb 27, 2013
Key facts
- NPI
- 1952539975
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 085004266 (IL)
- Practice address
- 1400 E Carroll St
Suite B
Macomb, IL 61455-1801 - Phone
- (309) 833-2500
- Fax
- (309) 833-1760
- NPI assigned
- Jun 29, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Pike Medical Consultants PC
Practice addresses (Care Compare)
762 N Dan Jones Rd
Gericare Indy
Avon, IN 46123-6213
Phone (317) 956-6288
7911 Michigan Rd
Indianapolis, IN 46268-1915
7911 N Michigan Rd
Indianapolis, IN 46268-1915
Phone (317) 956-6288
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090908000117 | IN | Practitioner - Physician Assistant | 8820143332 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085004266 | IL | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Indiana University Health Urgent Care Centers, LLC | Current |
Accepting new patients | |
| Indiana University Health Urgent Care Centers, LLC | Current |
Accepting new patients | |
| University Medical Diagnostic Associates, Inc. | Past | Accepting new patients | |
| Major Hospital | Past | Accepting new patients | |
| Henderson County Rural Health Center Inc | Past | Accepting new patients |
Locations
90 E Garner Rd
Brownsburg, IN 46112
Phone (225) 214-1031
Interoperability endpoints
- michelle.bowenpac.p29@direct.fhn-fqhc.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 085004266 | IL | Yes |
Addresses
Primary practice location
1400 E Carroll St
Suite B
Macomb, IL 61455-1801
Mailing address
PO Box 198
Oquawka, IL 61469-0198
Phone (309) 867-2202
Other providers in Macomb, IL
- Karen Blakeley
- Joann E. Bloomberg
- Amanda Michele Bolte
- Eric Botts
- Amanda Bourdon
- Bridgeway Inc
- Bridgeway Inc
- Bridgeway, Inc
- Bridgeway, Inc
- Bridgeway, Inc
All providers in Macomb, IL · Medical Physician Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.