Individual provider Active NPI

Melissa Ann Noronha, M.D.

  • Pediatrics Physician
  • Vancouver, WA
National Provider Identifier
1154717924
Registry record updated Feb 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301107610 Issued in MI
Practice address
7101 NE 137TH Ave
Vancouver, WA 98682-4933
Phone
(800) 813-2000
Fax
(877) 764-7131
NPI assigned
Apr 8, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301107610 MI Primary

Addresses

Primary practice location

7101 NE 137TH Ave
Vancouver, WA 98682-4933

Mailing address

500 NE Multnomah St Ste 100
Portland, OR 97232-2031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210225002941 OR Practitioner - Pediatric Medicine 9436451382 Reassigns benefits to 1 organization
I20210316000884 WA Practitioner - Pediatric Medicine 9436451382 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301107610MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Mar 15, 2021 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Pediatrics CurrentSince Mar 15, 2021 Accepting new patients

Locations

10180 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2880

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

500 NE Multnomah St
Ste 100
Portland, OR 97232
Phone (503) 499-5200

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

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.

NPI Registry JSON

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

{
    "created_epoch": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1154717924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NE MULTNOMAH ST STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7101 NE 137TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986824933",
            "telephone_number": "800-813-2000",
            "fax_number": "877-764-7131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORONHA",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-08",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301107610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.