Active NPI
Michelle Ruth Dhanak, M.D.
- Internal Medicine Physician
- Burlingame, CA
National Provider Identifier
1982691119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- G74482
- Practice address
- 1633 Old Bayshore Hwy
Suite 245
Burlingame, CA 94010 - Phone
- (650) 357-8834
- Fax
- (650) 357-8811
- NPI assigned
- Oct 3, 2005
- Last updated
- Feb 21, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | G74482 | CA | Primary |
Addresses
Primary practice location
1633 Old Bayshore Hwy
Suite 245
Burlingame, CA 94010
Mailing address
1633 Old Bayshore Hwy
Sutie 245
Burlingame, CA 94010
Phone (650) 357-8834
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G744821 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Aug 7, 2017 through Aug 7, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74482 | CA | MD | Clinical Social Worker |
| G74482 | CA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519171200000",
"number": "1982691119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1633 OLD BAYSHORE HWY",
"address_2": "SUTIE 245",
"city": "BURLINGAME",
"state": "CA",
"postal_code": "94010",
"telephone_number": "650-357-8834",
"fax_number": "650-357-8811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1633 OLD BAYSHORE HWY",
"address_2": "SUITE 245",
"city": "BURLINGAME",
"state": "CA",
"postal_code": "94010",
"telephone_number": "650-357-8834",
"fax_number": "650-357-8811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DHANAK",
"first_name": "MICHELLE",
"middle_name": "RUTH",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-10-03",
"last_updated": "2018-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "G74482",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G744821",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burlingame, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.