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MICHELLE LAKSANA PA-C
NPI 1851709414
Physician Assistant in Fontana, CA

Active since July 28, 2014PECOS Enrolled
16465 SIERRA LAKES PKWY, STE. 300, FONTANA, CA 92336(909) 429-2864 Get Directions Write a Review

NPPES record last updated: September 7, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Michelle Laksana Pa-c NPPES

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

MICHELLE LAKSANA PA-C (NPI 1851709414) is an individual physician assistant in Fontana, California, licensed in California (51795) and active in the NPI registry since July 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1851709414
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMICHELLE LAKSANACredential: PA-C
Location Address16465 SIERRA LAKES PKWY, STE. 300Fontana, CA 92336-1242
Mailing Address16465 Sierra Lakes Pkwy, Ste. 300Fontana, CA 92336-1242 · (909) 429-2864
Phone(909) 429-2864
Sole ProprietorNo
Enumeration DateJuly 28, 2014
Last NPPES UpdateSeptember 7, 2017
✔ NPI 1851709414 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in CA · 51795
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
16465 SIERRA LAKES PKWY, Fontana, CA 92336
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Michelle Laksana Pa-c 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92336 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
$91.88 typical visit price
range $59.60 – $179.42
Typical copayment $22.97 (range $14.90 – $44.85)
Most-billed visit code 99203
Established Patient
$74.08 typical visit price
range $19.37 – $146.42
Typical copayment $18.52 (range $4.84 – $36.60)
Most-billed visit code 99213
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 20

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

MOUNTAIN VIEW URGENT CARE GROUP, INC
Emergency Medicine
16465 SIERRA LAKES PKWY, SUITE 100
FONTANA, CA 92336
San Bernardino County (909) 434-1150
KATHRYN CHANG LIN MD
Pediatrics
16465 SIERRA LAKES PKWY, STE 245
FONTANA, CA 92336
San Bernardino County (909) 829-7337
ALAV MEDICAL CORPORATION
Family Medicine
16465 SIERRA LAKES PKWY, STE 220
FONTANA, CA 92336
San Bernardino County (909) 434-1123
DIANA M NAM MD
Pediatrics
16465 SIERRA LAKES PKWY, SUITE 250
FONTANA, CA 92336
San Bernardino County (909) 829-7337
TAMEEM HAZEM SABRY PA-C
Physician Assistant (Medical)
16465 SIERRA LAKES PKWY, STE 300
FONTANA, CA 92336
San Bernardino County (909) 429-2864
LAUREN KELLY CROSTIC PA-C
Physician Assistant
16465 SIERRA LAKES PKWY, 300
FONTANA, CA 92336
San Bernardino County (909) 429-2864
ASHAPURIMAA INC
Pharmacy (Community/Retail Pharmacy)
16465 SIERRA LAKES PKWY, STE 110
FONTANA, CA 92336
San Bernardino County (909) 574-9620
DR. MAGED FAYEZ IBRAHIM M.D.
Pediatrics
16465 SIERRA LAKES PKWY
FONTANA, CA 92336
San Bernardino County (909) 823-8000

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 Laksana's NPI number?

The NPI number for Michelle Laksana is 1851709414. It was assigned to this individual provider in the NPPES registry on July 28, 2014.

Where is Michelle Laksana located?

Michelle Laksana practices at 16465 Sierra Lakes Pkwy Ste. 300, Fontana, CA 92336. The listed phone number is (909) 429-2864.

What is Michelle Laksana's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Michelle Laksana enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Michelle Laksana was last updated on September 7, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.