MICHELLE LYNAE IVERSON (M.D.) – Anatomic Pathology & Clinical Pathology Physician, NPI 1912140302
Anatomic Pathology & Clinical Pathology Physician
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,584 PATHOLOGY in CA
Provider Addresses for MICHELLE LYNAE IVERSON (M.D.)
4301 NORTHSTAR WAY
MODESTO, CA 953561365
Phone: (209) 577-1200
Fax: (209) 577-6517
Type: Location
Jack in the Box, West Orangeburg Avenue, Modesto, Stanislaus County, California, 95350, United States
MODESTO, CA 953576768
Phone: (209) 577-1200
Fax: (209) 577-6517
Type: Mailing
PO BOX 681149
SAN ANTONIO, TX 782681149
Phone: (210) 558-6288
Fax: (210) 558-6289
Type: Mailing
4085 DE ZAVALA RD STE 200
SHAVANO PARK, TX 782492084
Phone: (210) 558-6288
Fax: (210) 558-6289
Type: Location
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: 2025-03-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210120002219 | I | Pathology | SD | TBD |
| I20250314001707 | I | Pathology | OH | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 859 | 527 | $0 |
| 88341 | Special stained specimen slides to examine tissue, each additional procedure | 321 | 84 | $0 |
| 88342 | Special stained specimen slides to examine tissue, initial procedure | 237 | 148 | $0 |
| 88300 | Pathology examination of tissue using a microscope, limited examination | 158 | 154 | $0 |
| 88304 | Pathology examination of tissue using a microscope, moderately low complexity | 94 | 89 | $0 |
Insurance plans in this area (ZIP 95356)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Psychiatry, Neurology | OH | |
| Physician Assistant | OH | |
| - | OH | |
| N E U R O L O G Y | GA | |
| Nurse Practitioner | OH | |
| Nurse Practitioner | OH | |
| Diagnostic Radiology | NC | |
| P A T H O L O G Y | CA | |
| - | OH | |
| - | OH |
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