Active NPI
Melissa A Dazo
- Pediatric Nurse Practitioner
- Washington, DC
National Provider Identifier
1013593771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- RN1038231
- Practice address
- 111 Michigan Ave NW
Washington, DC 20010-2916 - Phone
- (202) 476-5000
- NPI assigned
- Mar 23, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Registered Nurse | 163WP0200X | RN1038231 | DC | |
| Pediatric Nurse Practitioner | 363LP0200X | RN1038231 | DC | Primary |
Addresses
Primary practice location
111 Michigan Ave NW
Washington, DC 20010-2916
Mailing address
PO Box 744785
Atlanta, GA 30374-4785
Phone (202) 476-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210825000337 | DC | Practitioner - Nurse Practitioner | 3375948649 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Hospital | Current | Accepting new patients | |
| Children'S Hospital | Current | Accepting new patients | |
| Children'S Hospital | Current | Accepting new patients |
Locations
111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatrics Physician
- Washington, DC
- NPI 1780800128
-
- Community/Retail Pharmacy
- Silver Spring, MD
- NPI 1326878349
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618358400000",
"number": "1013593771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 744785",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303744785",
"telephone_number": "202-476-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 MICHIGAN AVE NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200102916",
"telephone_number": "202-476-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAZO",
"first_name": "MELISSA",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-23",
"last_updated": "2021-04-14",
"certification_date": "2021-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Pediatrics",
"state": "DC",
"license": "RN1038231",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "DC",
"license": "RN1038231",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.