Individual provider Active NPI

Lexi Nicole Mellin, PNP

  • Pediatric Nurse Practitioner
  • Detroit, MI
National Provider Identifier
1265304620
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
4704398106 Issued in MI
Practice address
3901 Beaubien St
Detroit, MI 48201-2196
Phone
(313) 745-5437
NPI assigned
Sep 23, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 4704398106 MI Primary
Registered Nurse 163W00000X 4704398106 MI

Addresses

Primary practice location

3901 Beaubien St
Detroit, MI 48201-2196

Mailing address

1656 Graefield Rd
Birmingham, MI 48009-7541
Phone (734) 624-9297

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20260311003459 MI Practitioner - Nurse Practitioner 2163905738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3901 Beaubien St
Suite H
Detroit, MI 48201-2196

8524 S Western Ave
Suite 108
Oklahoma City, OK 73139-9247

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704398106MIMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatricians CurrentSince Feb 27, 2026 Accepting new patients
University Pediatricians CurrentSince Feb 27, 2026 Accepting new patients

Locations

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

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": "1758585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1265304620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1656 GRAEFIELD RD",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480097541",
            "telephone_number": "734-624-9297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 BEAUBIEN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012196",
            "telephone_number": "313-745-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLIN",
        "first_name": "LEXI",
        "middle_name": "NICOLE",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-23",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704398106",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704398106",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.