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MICHELLE GRACE GRANSTROM MACDAVID MD
NPI 1790212751
Pediatrics in El Dorado Hills, CA

Active since May 21, 2017PECOS Enrolled
1264 HAWKS FLIGHT CT STE 100, EL DORADO HILLS, CA 95762(916) 933-4222(916) 933-5574 Get Directions Write a Review

NPPES record last updated: September 24, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 24, 2024, Apr 24, 2024, Apr 12, 2022 and 2 more (5 updates tracked since 2017).

About Michelle Grace Granstrom Macdavid Md NPPES

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

MICHELLE GRACE GRANSTROM MACDAVID MD (NPI 1790212751) is an individual pediatrics provider in El Dorado Hills, California, licensed in California (A195577) and active in the NPI registry since May 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790212751
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameMICHELLE GRACE GRANSTROM MACDAVIDCredential: MD
Location Address1264 HAWKS FLIGHT CT STE 100El Dorado Hills, CA 95762-9354
Mailing Address3400 Data DrRancho Cordova, CA 95670-7956
Phone(916) 933-4222
Fax(916) 933-5574
Sole ProprietorNo
Enumeration DateMay 21, 2017
Last NPPES UpdateSeptember 24, 20245 updates tracked since enumeration
NPPES CertifiedSeptember 24, 2024
✔ NPI 1790212751 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · A195577
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
1264 HAWKS FLIGHT CT STE 100, El Dorado Hills, CA 95762
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Michelle Grace Granstrom Macdavid Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Macdavid reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Chw Medical Foundation
0.2 mi
Multi-Specialty
4987 GOLDEN FOOTHILL PKWY
El Dorado Hills, CA 95762
  • Reassigned Medicare billing, California enrollment
  • Medicare enrollment name: Dignity Health Medical Foundation
  • 1,191 clinicians in this Medicare group
NPI 1942430566 (916) 933-4222

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95762 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$92.61 typical visit price
range $60.44 – $180.85
Typical copayment $23.15 (range $15.11 – $45.21)
Most-billed visit code 99203
Established Patient
$105.95 typical visit price
range $19.88 – $148.15
Typical copayment $26.48 (range $4.97 – $37.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 10

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

SANA HANAFI MD
Family Medicine
1264 HAWKS FLIGHT CT STE 100
EL DORADO HILLS, CA 95762
El Dorado County (916) 933-4222
ALICJA CORRELL DO
Family Medicine
1264 HAWKS FLIGHT CT STE 100
EL DORADO HILLS, CA 95762
El Dorado County (916) 939-8400
JAMIE N MARTIN PA-C
Physician Assistant
1264 HAWKS FLIGHT CT STE 100
EL DORADO HILLS, CA 95762
El Dorado County (916) 933-4222
SHIDEH CHINICHIAN M.D.
Family Medicine
1264 HAWKS FLIGHT CT STE 100
EL DORADO HILLS, CA 95762
El Dorado County (916) 939-8400
MRS. VICTORIA IRENE BENNETT PA-C
Physician Assistant (Medical)
1264 HAWKS FLIGHT CT STE 100
EL DORADO HILLS, CA 95762
El Dorado County (916) 939-8400
MRS. TERESA ANN CUTHBERTSON NP
Nurse Practitioner (Family)
1264 HAWKS FLIGHT CT STE 100
EL DORADO HILLS, CA 95762
El Dorado County (916) 939-8400
DINA MARIE MEDEIROS PA-C
Physician Assistant
1264 HAWKS FLIGHT CT STE 100
EL DORADO HILLS, CA 95762
El Dorado County (916) 939-8400
DR. EFREN F WU MD
Family Medicine
1264 HAWKS FLIGHT CT STE 100
EL DORADO HILLS, CA 95762
El Dorado County (916) 939-8400

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 Macdavid's NPI number?

The NPI number for Michelle Macdavid is 1790212751. It was assigned to this individual provider in the NPPES registry on May 21, 2017.

Where is Michelle Macdavid located?

Michelle Macdavid practices at 1264 Hawks Flight Ct Ste 100, El Dorado Hills, CA 95762. The listed phone number is (916) 933-4222.

What is Michelle Macdavid's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Michelle Macdavid enrolled in Medicare?

Yes. Michelle Macdavid is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Michelle Macdavid's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michelle Macdavid reassigns Medicare benefits to Chw Medical Foundation (El Dorado Hills, 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 Macdavid'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 Macdavid was last updated on September 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.