Individual provider Active NPI

Melanie Kreiss, PA-C

  • Physician Assistant
  • Redding, CA
National Provider Identifier
1215573035
Registry record updated May 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
57386 Issued in CA
Practice address
2891 Churn Creek Rd
Redding, CA 96002-1148
Phone
(530) 221-6306
NPI assigned
Nov 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2020

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 57386 CA Primary

Addresses

Primary practice location

2891 Churn Creek Rd
Redding, CA 96002-1148

Mailing address

2891 Churn Creek Rd
Redding, CA 96002-1148
Phone (530) 221-6303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20200121000430 CA Practitioner - Physician Assistant 2567897598 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57386CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Interventional Pain Solutions PC Past Accepting new patients

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": "1574812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589846400000",
    "number": "1215573035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2891 CHURN CREEK RD",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960021148",
            "telephone_number": "530-221-6303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2891 CHURN CREEK RD",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960021148",
            "telephone_number": "530-221-6306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREISS",
        "first_name": "MELANIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-27",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "57386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.