Individual provider Active NPI

Melinda Kathleen Carson, PA-C

  • Physician Assistant
  • Palm City, FL
National Provider Identifier
1265783161
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9106893 Issued in FL
Practice address
2339 SW Martin Hwy
Palm City, FL 34990-3222
Phone
(772) 222-5302
Fax
(772) 210-0986
NPI assigned
Oct 2, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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 PA9106893 FL Primary

Addresses

Primary practice location

2339 SW Martin Hwy
Palm City, FL 34990-3222

Mailing address

2339 SW Martin Hwy
Palm City, FL 34990-3222
Phone (772) 222-5302

Other practice location 1

2351 SW Martin Hwy
Palm City, FL 34990-3222
Phone (772) 324-9337

Other practice location 2

1070 SW Gatlin Blvd
Port St Lucie, FL 34953-3223
Phone (772) 408-9434

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20130131000366 FL Practitioner - Physician Assistant 9032363981 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Access 365 Urgent Care LLCGroup PAC ID 9830468727, 8 clinicians
Back in Action Medical Center LLCGroup PAC ID 7810272473, 12 clinicians

Practice addresses (Care Compare)

2339 SW Martin Hwy
Palm City, FL 34990-3222
Phone (772) 222-5302

2351 SW Martin Hwy
Palm City, FL 34990-3222
Phone (772) 324-9337

Hospital & facility affiliations

  • Cleveland Clinic Martin North Hospital Hospital, Stuart, FL, CCN 100044

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Back in Action Medical Center LLC CurrentSince Sep 9, 2024 Accepting new patients
Glynnis J. Lyons, DO, PA Past Accepting new patients

Locations

2351 SW Martin Hwy
Palm City, FL 34990
Phone (772) 324-8337

Networks

  • Freedom Health HMO Network

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1265783161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2339 SW MARTIN HWY",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349903222",
            "telephone_number": "772-222-5302",
            "fax_number": "772-210-0986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2339 SW MARTIN HWY",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349903222",
            "telephone_number": "772-222-5302",
            "fax_number": "772-210-0986"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2351 SW Martin Hwy",
            "address_purpose": "LOCATION",
            "city": "Palm City",
            "state": "FL",
            "postal_code": "349903222",
            "country_code": "US",
            "telephone_number": "772-324-9337",
            "fax_number": "772-324-9347",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1070 SW Gatlin Blvd",
            "address_purpose": "LOCATION",
            "city": "Port St Lucie",
            "state": "FL",
            "postal_code": "349533223",
            "country_code": "US",
            "telephone_number": "772-408-9434",
            "fax_number": "772-210-0986",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARSON",
        "first_name": "MELINDA",
        "middle_name": "KATHLEEN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-02",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm City, FL

Sources for this page

Verify at the official NPI Registry.