Individual provider Active NPI

Ryan Melchers, PA-C

  • Physician Assistant
  • Virginia Beach, VA
National Provider Identifier
1114638988
Registry record updated Jul 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4421 Virginia Beach Blvd Ste 112
Virginia Beach, VA 23462-3114
Phone
(757) 963-1488
NPI assigned
Dec 12, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

4421 Virginia Beach Blvd Ste 112
Virginia Beach, VA 23462-3114

Mailing address

4421 Virginia Beach Blvd Ste 112
Virginia Beach, VA 23462-3114
Phone (757) 963-1488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230224002105 VA Practitioner - Physician Assistant 7618340498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1540 Breezeport Way
Suite 100
Suffolk, VA 23435-3752
Phone (757) 538-7275

4421 Virginia Beach Blvd
VA Beach, VA 23462-3114

860 Omni Blvd
Newport News, VA 23606-4430

860 Omni Blvd
Newport News, VA 23606-4434

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physicians Multispecialty Group PC CurrentSince Mar 1, 2023 Accepting new patients
Tidewater Physicians Multispecialty Group PC CurrentSince Mar 1, 2023 Accepting new patients

Locations

860 Omni Blvd
Ste 128
Newport News, VA 23606

860 Omni Blvd
Newport News, VA 23606
Phone (757) 369-8138

827 Diligence Dr
Ste 100
Newport News, VA 23606

729 Thimble Shoals Blvd
Newport News, VA 23606
Phone (757) 874-1077

860 Omni Blvd
Ste 105
Newport News, VA 23606
Phone (757) 873-0952

1540 Breezeport Way
Ste 101
Suffolk, VA 23435

4421 Virginia Beach Blvd
Ste 112
Virginia Beach, VA 23462
Phone (757) 963-1488

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

Organizations & group practices 2

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1670803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690070400000",
    "number": "1114638988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4421 VIRGINIA BEACH BLVD STE 112",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234623114",
            "telephone_number": "757-963-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4421 VIRGINIA BEACH BLVD STE 112",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234623114",
            "telephone_number": "757-963-1488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELCHERS",
        "first_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-12",
        "last_updated": "2023-07-23",
        "certification_date": "2023-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.