Individual provider Active NPI

Melissa Cecilia Walsh, MD

  • Pediatrics Physician
  • Mountlake Terrace, WA
National Provider Identifier
1275644874
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ML20008042 Issued in WA
Practice address
23511 56TH Ave W Ste 105
Mountlake Terrace, WA 98043-5285
Phone
(206) 546-2421
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ML20008042 WA Primary

Addresses

Primary practice location

23511 56TH Ave W Ste 105
Mountlake Terrace, WA 98043-5285

Mailing address

23511 56TH Ave W Ste 105
Mountlake Terrace, WA 98043-5285
Phone (206) 546-2421

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240828001336 WA Practitioner - Pediatric Medicine 7719315324 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ML20008042WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Umbrella Pediatrics PC Pediatrics CurrentSince May 4, 2024 Accepting new patients
Seattle Children'S Hospital Past Accepting new patients
Richmond Pediatric Clinic Inc. P.S. Pediatrics Past Accepting new patients

Locations

23511 56th Ave W
Ste 105
Mountlake Terrace, WA 98043
Phone (206) 546-2421

Interoperability endpoints

  • Direct secure messaging: mwalsh7129@direct.seattlechildrens.org

Organizations & group practices 3

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1275644874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23511 56TH AVE W STE 105",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980435285",
            "telephone_number": "206-546-2421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23511 56TH AVE W STE 105",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980435285",
            "telephone_number": "206-546-2421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "MELISSA",
        "middle_name": "CECILIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "ML20008042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountlake Terrace, WA

Sources for this page

Verify at the official NPI Registry.