Individual provider Active NPI

Michelle Marie Roberts, PA-C

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1992089478
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA21765 Issued in CA
Practice address
1225 Wilshire Blvd
Los Angeles, CA 90017-1901
Phone
(213) 977-2121
NPI assigned
Oct 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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 PA21765 CA Primary

Addresses

Primary practice location

1225 Wilshire Blvd
Los Angeles, CA 90017-1901

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (213) 977-2121

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address michelle.roberts@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120130000850 CA Practitioner - Physician Assistant 7719144906 Reassigns benefits to 4 organizations
I20230617000277 TX Practitioner - Physician Assistant 7719144906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone (916) 734-2011

3301 C St
Sacramento, CA 95816-3300
Phone (916) 734-6805

Hospital & facility affiliations

  • University of California Davis Medical Center Hospital, Sacramento, CA, CCN 050599

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Jun 28, 2020 Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince May 22, 2023 Accepting new patients
Pine Ridge Indian Health Service Hospital Current Accepting new patients
Regents of the Univ of Ca CurrentSince Dec 12, 2022 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Jun 28, 2020 Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince May 22, 2023 Accepting new patients
Regents of the Univ of Ca CurrentSince Dec 12, 2022 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients

Locations

300 W Huntington Dr
Arcadia, CA 91007
Phone (626) 445-4441

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

1420 S Central Ave
Glendale, CA 91204
Phone (818) 502-1900

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1225 Wilshire Blvd
Los Angeles, CA 90017
Phone (213) 482-2741

3301 C St
Sacramento, CA 95816
Phone (916) 734-6111

4868 X St
Sacramento, CA 95817
Phone (916) 703-1503

3301 C St
Ste 1100
Sacramento, CA 95816
Phone (916) 734-7844

438 W Las Tunas Dr
San Gabriel, CA 91776
Phone (626) 289-5454

18321 Clark St
Tarzana, CA 91356
Phone (310) 423-6744

Interoperability endpoints

  • Direct secure messaging: michelle.roberts@direct.usc.edu

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 1

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": "1317600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1992089478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "213-977-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171901",
            "telephone_number": "213-977-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-03",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michelle.roberts@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1225 Wilshire Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900171901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.