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MICHELLE GAVIN D.O.
NPI 1477961084
Student in an Organized Health Care Education/Training Program in Los Angeles, CA

Active since July 27, 2014PECOS EnrolledAccepts Medicare Assignment
1400 S GRAND AVE STE 101, LOS ANGELES, CA 90015(213) 744-0801(213) 741-1423 Get Directions Write a Review

NPPES record last updated: January 10, 2022. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Michelle Gavin D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHELLE GAVIN D.O. (NPI 1477961084) is an individual student in an organized health care education/training program in Los Angeles, California and active in the NPI registry since July 2014. She is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1477961084
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameMICHELLE GAVINCredential: D.O.
Location Address1400 S GRAND AVE STE 101Los Angeles, CA 90015-3048
Mailing Address1400 S Grand Ave Ste 101Los Angeles, CA 90015-3048 · (213) 744-0801 · Fax (213) 741-1423
Phone(213) 744-0801
Fax(213) 741-1423
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateJuly 27, 2014
Last NPPES UpdateJanuary 10, 2022
✔ NPI 1477961084 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1400 S GRAND AVE STE 101, Los Angeles, CA 90015
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Other Names 1

Other Name (5)Michelle Petrovsky D.o.

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Michelle Gavin D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5193006716
PECOS Enrollment IDI20161219002484
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Michelle Gavin reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc
309 mi
Internal Medicine
710 LAWRENCE EXPRESSWAY
Santa Clara, CA 95051
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1073606299 (408) 851-1000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ROBERTO FERNANDO JORDAN MD
Family Medicine
1400 S GRAND AVE STE 101
LOS ANGELES, CA 90015
Los Angeles County (213) 744-0801
MICHAEL DOWNING MD
Family Medicine
1400 S GRAND AVE STE 101
LOS ANGELES, CA 90015
Los Angeles County (213) 744-0801
DR. TONY TRUONG MD
Family Medicine
1400 S GRAND AVE STE 101
LOS ANGELES, CA 90015
Los Angeles County (213) 744-0801
GABRIELA FLORES
Social Worker
1400 S GRAND AVE STE 101
LOS ANGELES, CA 90015
Los Angeles County (213) 744-2236
DR. ARNEL ANTHONY BALBUENA M.D.
Family Medicine
1400 S GRAND AVE STE 101
LOS ANGELES, CA 90015
Los Angeles County (213) 744-0801
DR. MICHELLE CRESPO MD, MPH
Family Medicine
1400 S GRAND AVE STE 101
LOS ANGELES, CA 90015
Los Angeles County (213) 741-1106
DR. TRACEY LEE NORTON D.O.
Family Medicine (Adolescent Medicine)
1400 S GRAND AVE STE 101
LOS ANGELES, CA 90015
Los Angeles County (213) 744-0801
EUN JUNG KIM D.O.
Student in an Organized Health Care Education/Training Program
1400 S GRAND AVE STE 101
LOS ANGELES, CA 90015
Los Angeles County (213) 744-0801

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michelle Gavin's NPI number?

The NPI number for Michelle Gavin is 1477961084. It was assigned to this individual provider in the NPPES registry on July 27, 2014. The provider is also known as Michelle Petrovsky D.O..

Where is Michelle Gavin located?

Michelle Gavin practices at 1400 S Grand Ave Ste 101, Los Angeles, CA 90015. The listed phone number is (213) 744-0801.

What is Michelle Gavin's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Michelle Gavin enrolled in Medicare?

Yes. Michelle Gavin is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Michelle Gavin's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michelle Gavin reassigns Medicare benefits to Permanente Medical Group Inc (Santa Clara, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Michelle Gavin's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Michelle Gavin was last updated on January 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.