ANDREA MICHELLE HALL (NP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1104576271

ANDREA MICHELLE HALL (NP) is a healthcare provider. based in Gardena, California. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 95019371 (CA). The NPI Number for ANDREA MICHELLE HALL (NP) is 1104576271

Main info

Female
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
ANDREA MICHELLE HALL (NP)
NPI
1104576271
Phone
(877) 515-8113
Address
1225 W 190th St Ste 280
Enumeration Date
24 March 2022
Last Update Date
18 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8775158113
Graduation Year
2021 (5 years ago)
PAC ID
4385089598
Group Practice PAC ID
5092099523
Professional Enrollment ID
I20240227004632
Address ID
CA949453269NO7250XBLVD302
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:4State licenses:3Digital endpointsOther names

16,353 NURSE PRACTITIONER in CA

Provider Addresses for ANDREA MICHELLE HALL (NP)

  • 1225 W 190th St Ste 280

    Gardena, CA 902484305

    Phone: (877) 515-8113

    Type: Location

  • 1941 PHINIZY RD

    AUGUSTA, GA 309065173

    Phone: (706) 849-3630

    Type: Location

  • 300 E. HOSPITAL RD.

    FORT EISENHOWER, GA 30905

    Phone: (706) 787-5605

    Type: Location

  • PO BOX 26

    GROVETOWN, GA 308130026

    Phone: (216) 269-2104

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-05-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 3 Medicare enrollment records; no due dates published yet.

Enrollment records

3

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240227004632INurse PractitionerCATBD
I20250507002602INurse PractitionerHITBD
I20250520002319INurse PractitionerGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 90248)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5092099523View full group profile
NameSpecialtyState
P S Y C H I A T R YOR
P S Y C H I A T R YCA
Nurse PractitionerCA
Nurse PractitionerCA
Nurse PractitionerFL
Nurse PractitionerCA
Nurse PractitionerCA
Nurse PractitionerCA
Nurse PractitionerCA
Nurse PractitionerCA

Reviews

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Frequently asked questions

Does ANDREA MICHELLE HALL (NP) have a public NPI I can cite?
Public records show ANDREA MICHELLE HALL (NP) under NPI 1104576271.
Quick check: is ANDREA MICHELLE HALL (NP) active?
Public NPPES data shows ANDREA MICHELLE HALL (NP) with an active NPI status right now.
What services align with ANDREA MICHELLE HALL (NP)'s listing?
ANDREA MICHELLE HALL (NP)'s public classification highlights Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Can patients visit ANDREA MICHELLE HALL (NP) in Gardena, California?
For routing, start with Gardena, California for ANDREA MICHELLE HALL (NP), then verify phone and hours locally.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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