Individual provider Active NPI

Melissa Teresa Fagonde, MD

  • Family Medicine Physician
  • Washington, DC
National Provider Identifier
1164715926
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD042650 Issued in DC
Practice address
1160 Varnum Street , NE
Depaul 110
Washington, DC 20017-2107
Phone
(202) 448-4090
Fax
(202) 448-4093
NPI assigned
May 26, 2011
Last updated
Jan 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D078399 MD
Family Medicine Physician 207Q00000X MD042650 DC Primary

Addresses

Primary practice location

1160 Varnum Street , NE
Depaul 110
Washington, DC 20017-2107

Mailing address

1150 Varnum St NE RM 407
Washington, DC 20017-2180
Phone (202) 854-4090

Other names 1

  • Dr. Melissa Teresa Franco Other name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141028002724 DC Practitioner - Family Practice 2567683949 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
George Washington University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Washington Health InstituteGroup PAC ID 1456696368, 18 clinicians
Providence Health Services IncGroup PAC ID 4385541622, 17 clinicians

Practice addresses (Care Compare)

1140 Varnum St NE
Suite 203
Washington, DC 20017-2153
Phone (240) 426-8890

1160 Varnum St NE Depaul
110 PHS Family Medicine and Pediatrics
Washington, DC 20017-2107
Phone (202) 854-4090

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD042650DCMDFamily Medicine Physician
D078399MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unity Health Care, Inc. CurrentSince Aug 31, 2014 Accepting new patients
Unity Health Care Inc. CurrentSince Aug 31, 2014 Accepting new patients
Providence Health Services, Inc CurrentSince Sep 1, 2014 Accepting new patients
Providence Health Services, Inc Family Medicine CurrentSince Feb 9, 2020 Accepting new patients
Providence Health Services Inc Family Medicine CurrentSince Sep 1, 2014 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1140 Varnum St NE
Ste 103
Washington, DC 20017
Phone (202) 723-8768

1140 Varnum St NE
Ste 203
Washington, DC 20017
Phone (202) 525-5175

1150 Varnum St NE
Washington, DC 20017
Phone (202) 269-7000

1150 Varnum St NE
Rm 407
Washington, DC 20017
Phone (202) 854-4069

1150 Varnum St NE
Ste 110
Washington, DC 20017

1160 Varnum St NE
Ste 110
Washington, DC 20017
Phone (202) 854-4080

128 M St NW
Washington, DC 20001
Phone (202) 682-3840

1310 Southern Ave SE
Washington, DC 20032
Phone (202) 574-6000

Organizations & group practices 7

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.

Hospital & facility affiliations 3

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": "1306368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1164715926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 VARNUM ST NE RM 407",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200172180",
            "telephone_number": "202-854-4090",
            "fax_number": "202-854-4093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 VARNUM STREET , NE",
            "address_2": "DEPAUL 110",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200172107",
            "telephone_number": "202-448-4090",
            "fax_number": "202-448-4093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGONDE",
        "first_name": "MELISSA",
        "middle_name": "TERESA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-26",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D078399",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DC",
            "license": "MD042650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "FRANCO",
            "middle_name": "TERESA",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.