Individual provider Active NPI

Vena P. Melendez, P.A-C

  • Physician Assistant
  • Mill Creek, WA
National Provider Identifier
1245326115
Registry record updated Dec 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60066499 Issued in WA
Practice address
15906 Mill Creek Blvd Ste 105
Mill Creek, WA 98012-1797
Phone
(425) 385-2009
Fax
(425) 939-0807
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA15783 CA
Physician Assistant 363A00000X PA60066499 WA Primary

Addresses

Primary practice location

15906 Mill Creek Blvd Ste 105
Mill Creek, WA 98012-1797

Mailing address

15906 Mill Creek Blvd Ste 105
Mill Creek, WA 98012-1797
Phone (425) 385-2009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20100514000402 WA Practitioner - Physician Assistant 2365330743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Silver Falls Dermatology LLCGroup PAC ID 5890863492, 100 clinicians

Practice addresses (Care Compare)

1515 116TH Ave NE
Suite 307
Bellevue, WA 98004-3811
Phone (425) 999-2628

15906 Mill Creek Blvd
Suite 105
Mill Creek, WA 98012-1797
Phone (425) 385-2009

3131 Nassau St
Suite 101
Everett, WA 98201-4137
Phone (425) 385-2009

4407 Fairmont Ave
Port Angeles, WA 98363-9514
Phone (503) 362-8385

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA15783CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Falls Dermatology, LLC Physician Assistant CurrentSince Apr 1, 2021 Accepting new patients

Locations

1793 13th St SE
Salem, OR 97302
Phone 50336283851283

16410 Smokey Point Blvd
Ste 300
Arlington, WA 98223

1515 116th Ave NE
Ste 307
Bellevue, WA 98004
Phone (425) 999-2628

3131 Nassau St
#101
Everett, WA 98201
Phone (425) 339-8888

1106 Douglas St
Ste F
Longview, WA 98632
Phone (360) 636-4500

15906 Mill Creek Blvd
Ste 105
Mill Creek, WA 98012
Phone 4253852009111

14090 Fryelands Blvd SE
Ste 218
Monroe, WA 98272

11011 Meridian Ave N
Ste 102
Seattle, WA 98133
Phone (206) 859-5777

Interoperability endpoints

  • Direct secure messaging: venam@frontierdermpartners.emadirect.md

Organizations & group practices 1

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291852800000",
    "number": "1245326115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15906 MILL CREEK BLVD STE 105",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121797",
            "telephone_number": "425-385-2009",
            "fax_number": "425-939-0807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15906 MILL CREEK BLVD STE 105",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121797",
            "telephone_number": "425-385-2009",
            "fax_number": "425-939-0807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELENDEZ",
        "first_name": "VENA",
        "middle_name": "P.",
        "name_prefix": "Mrs.",
        "credential": "P.A-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2010-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA15783",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60066499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Creek, WA

Sources for this page

Verify at the official NPI Registry.