Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Michael J Cavanaugh

Individual provider Physician Assistant · NPI 1912396144

Michael J Cavanaugh is a Physician Assistant in Fort Defiance, Arizona. Qualified in 2014, 12 years ago. Works from 3 locations and accepts Medicare assignment. Licensed in Colorado and Minnesota.

Years since qualifying
12
Licensed in
CO, MN
In the registry since
2015
Specialties on file
2

Practice location Address checks out

Corner Of Route N12 And N7
Fort Defiance, AZ 86504
Phone: (928) 729-8000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1311 N Mildred Rd, Cortez, CO 81321-2231 — (970) 565-6666
  • 1010 Three Springs Blvd, Durango, CO 81301-8296 — (970) 247-4311

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA.0004654 (CO)
Physician Assistant Taxonomy 363A00000X · Licence 11810 (MN)

Record details

NPI number1912396144
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 12, 2015
Last updated in NPPESMarch 20, 2026
Certification dateMarch 20, 2026
Mailing addressPo Box 649, Fort Defiance, AZ 86504-0649

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Fort Defiance