Melissa Sue Anderson, PA-C
Individual provider Active NPI Physician Assistant · Hillman, MI
NPI 1144521170 · NPPES record last updated Feb 1, 2017
Key facts
- NPI
- 1144521170
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 1144521170 (MI)
- Practice address
- 15774 State St
Hillman, MI 49746-7961 - Phone
- (989) 742-4583
- Fax
- (989) 742-2183
- NPI assigned
- Nov 8, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 19
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Thunder Bay Community Health Service Inc
Practice addresses (Care Compare)
PO Box
Hillman, MI 49746-0427
Hospital & facility affiliations
- Mymichigan Medical Center Alpena
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI, AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151211002201 | MI | Practitioner - Physician Assistant | 1557540457 | Reassigns benefits to 4 organizations |
| I20250813002246 | AZ | Practitioner - Physician Assistant | 1557540457 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11192 | AZ | MD | Physical Therapist |
| 1144521170 | MI | MD | Physician Assistant |
| PA60229706 | WA | MD | Physician Assistant |
| PA001242 | ME | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thunder Bay Community Health Service, Inc | Current |
Accepting new patients | |
| Hometown Urgent Care of Michigan, P.C. | Current | Accepting new patients | |
| Thunder Bay Community Health Service, Inc | Current |
Accepting new patients | |
| Hometown Urgent Care of Michigan, PC | Current |
Accepting new patients | |
| Hometown Urgent Care of Michigan, P.C. | Current |
Accepting new patients | |
| Physicians Immediate Care LTD | Past | Accepting new patients | |
| Docs PLLC | Past |
Accepting new patients | |
| Thunder Bay Community Health Service, Inc | Past | Accepting new patients |
Locations
1131 M 32 W
Alpena, MI 49707
Phone (989) 250-1925
11899 M 32
Atlanta, MI 49709
Phone (989) 785-4855
9065 E 34 Rd
Cadillac, MI 49601
Phone (231) 577-5017
1634 Gull Rd
Kalamazoo, MI 49048
Phone (269) 903-2835
205 S Bradley Hwy
Rogers City, MI 49779
Phone (989) 356-0141
Interoperability endpoints
- melissa.anderson.1@21803.direct.athenahealth.com
- melissa.anderson.1@19654.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA001242 | ME | |
| Physician Assistant | 363A00000X | PA60229706 | WA | |
| Physician Assistant | 363A00000X | 1144521170 | MI | Yes |
Addresses
Primary practice location
15774 State St
Hillman, MI 49746-7961
Mailing address
PO Box 427
Hillman, MI 49746-0427
Phone (989) 354-2197
Other providers in Hillman, MI
All providers in Hillman, MI · Physician Assistant in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.