Individual provider Active NPI

Michelle Ann Kopp, PA-C

  • Physician Assistant
  • Highland, CA
National Provider Identifier
1982066338
Registry record updated Dec 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
53264 Issued in CA
Practice address
7000 Boulder Ave
Highland, CA 92346-3348
Phone
(909) 862-1191
NPI assigned
Mar 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 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 53264 CA Primary

Addresses

Primary practice location

7000 Boulder Ave
Highland, CA 92346-3348

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 579-3203

Other practice location 1

236 Cajon St
Redlands, CA 92373-5202
Phone (909) 335-4182

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
I20160816002713 CA Practitioner - Physician Assistant 7618262510 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Beaver Medical Group P CGroup PAC ID 0547164295, 251 clinicians

Practice addresses (Care Compare)

7000 Boulder Ave
Highland, CA 92346-3348
Phone (909) 862-1191

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53264CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Beaver Medical Group P C CurrentSince Jun 15, 2016 Accepting new patients
Centers for Family Medicine GP Current Accepting new patients
Cassidy Medical Group Inc. Current Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Nov 1, 2025 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Nov 1, 2025 Accepting new patients
Beaver Medical Group P C CurrentSince Jun 15, 2016 Accepting new patients
San Gorgonio Memorial Hospital Past Accepting new patients
Redlands Community Hospital Past Accepting new patients
Beaver Medical Group P C Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

2910 Jefferson St
Ste 100
Carlsbad, CA 92008
Phone (760) 729-8600

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

7000 Boulder Ave
Highland, CA 92346

2 W Fern Ave
#1112
Redlands, CA 92373

1615 Orange Tree Ln
Redlands, CA 92374
Phone (909) 335-4102

2 W Fern Ave
Redlands, CA 92373
Phone (909) 335-4137

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

145 Thunder Dr
#1182
Vista, CA 92083
Phone (760) 941-9002

145 Thunder Dr
Vista, CA 92083
Phone (760) 630-5487

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mkopp11131@epiclp.direct-ci.com

Organizations & group practices 9

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": "1458777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766880000000",
    "number": "1982066338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-579-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 BOULDER AVE",
            "city": "HIGHLAND",
            "state": "CA",
            "postal_code": "923463348",
            "telephone_number": "909-862-1191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "236 Cajon St",
            "address_purpose": "LOCATION",
            "city": "Redlands",
            "state": "CA",
            "postal_code": "923735202",
            "country_code": "US",
            "telephone_number": "909-335-4182",
            "fax_number": "909-583-2591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOPP",
        "first_name": "MICHELLE",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-24",
        "last_updated": "2025-12-28",
        "certification_date": "2025-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "53264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland, CA

Sources for this page

Verify at the official NPI Registry.