Individual provider Active NPI

Melissa Kay Benbow, MD

  • Pediatrics Physician
  • Lansing, MI
National Provider Identifier
1053564617
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301104293 Issued in MI
Practice address
13750 S Sedona Pkwy
Lansing, MI 48906-8101
Phone
(517) 353-4000
Fax
(517) 353-4001
NPI assigned
Oct 28, 2008
Last updated
Jul 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35.095877 OH
Pediatrics Physician 208000000X 4301104293 MI Primary

Addresses

Primary practice location

13750 S Sedona Pkwy
Lansing, MI 48906-8101

Mailing address

804 Service Rd Ste A202
East Lansing, MI 48824-7015
Phone (517) 353-4000

Other practice location 1

5303 S Cedar St
Lansing, MI 48911-3800
Phone (517) 887-4305

Other practice location 2

1600 W Grand River Ave Ste 2
Okemos, MI 48864-2394
Phone (517) 349-6560

Other practice location 3

7335 Westshire Dr Ste 102
Lansing, MI 48917-9703
Phone (517) 622-1012

Other identifiers 4

IdentifierTypeStateIssuer
4301104293OtherMIMI MEDICAL LICENSE
57-014989OtherOHTRAINING CERTIFICATE
1053564617MedicaidMI
35.095877OtherOHOHIO STATE MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140227001599 MI Practitioner - Pediatric Medicine 0446480073 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301104293MIMDPediatrics Physician
35.095877OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Msu Health Care Inc. CurrentSince Jul 1, 2020 Accepting new patients
Msu Health Care Inc CurrentSince Jul 1, 2020 Accepting new patients
Michigan State University CurrentSince Sep 1, 2015 Accepting new patients
Edward W Sparrow Hospital Association Past Accepting new patients
County of Ingham Past Accepting new patients

Locations

4660 S Hagadorn Rd
Ste 500
East Lansing, MI 48823
Phone (517) 432-6144

804 Service Rd
Ste A109F
East Lansing, MI 48824

804 Service Rd
Ste A202
East Lansing, MI 48824
Phone (517) 884-2976

13750 S Sedona Pkwy
Ste 2
Lansing, MI 48906
Phone (517) 353-4000

7335 Westshire Dr
Ste 102
Lansing, MI 48917
Phone (517) 622-1012

1600 W Grand River Ave
Ste 2
Okemos, MI 48864
Phone (517) 349-6560

Interoperability endpoints

  • Direct secure messaging: melissa.benbow.1@25394.direct.athenahealth.com
  • Direct secure messaging: melissa.benbow.p1@direct.ichd.nextgenshare.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1053564617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD STE A202",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "517-353-4000",
            "fax_number": "517-353-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13750 S SEDONA PKWY",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489068101",
            "telephone_number": "517-353-4000",
            "fax_number": "517-353-4001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5303 S Cedar St",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489113800",
            "country_code": "US",
            "telephone_number": "517-887-4305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 W Grand River Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "Okemos",
            "state": "MI",
            "postal_code": "488642394",
            "country_code": "US",
            "telephone_number": "517-349-6560",
            "fax_number": "517-349-5796",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7335 Westshire Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489179703",
            "country_code": "US",
            "telephone_number": "517-622-1012",
            "fax_number": "517-622-1033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENBOW",
        "first_name": "MELISSA",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.095877",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301104293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI MEDICAL LICENSE",
            "identifier": "4301104293",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAINING CERTIFICATE",
            "identifier": "57-014989",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053564617",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO STATE MEDICAL LICENSE",
            "identifier": "35.095877",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.