Individual provider Active NPI

Melanie Mary Matti, NP

  • Family Nurse Practitioner
  • West Bloomfield, MI
National Provider Identifier
1316779762
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0000 Issued in MI
Practice address
4079 Winterset LN
West Bloomfield, MI 48323-3154
Phone
(248) 505-7838
NPI assigned
Aug 15, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0000 MI Primary

Addresses

Primary practice location

4079 Winterset LN
West Bloomfield, MI 48323-3154

Mailing address

4079 Winterset LN
West Bloomfield, MI 48323-3154

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
I20251105002786 MI Practitioner - Nurse Practitioner 0042700338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6825 Dixie Hwy
Suite B
Clarkston, MI 48346

PO Box
Suite 7712
Bloomfield Hills, MI 48302-7712

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0000MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Endocrine & Diabetes Consultants PC CurrentSince Oct 15, 2025 Accepting new patients

Locations

2970 Crooks Rd
Ste A
Rochester Hills, MI 48309
Phone (248) 651-5353

2970 Crooks Rd
Rochester Hills, MI 48309
Phone (248) 844-0200

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.

Hospital & facility affiliations 3

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": "1723680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1316779762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4079 WINTERSET LN",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483233154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4079 WINTERSET LN",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483233154",
            "telephone_number": "248-505-7838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTI",
        "first_name": "MELANIE",
        "middle_name": "MARY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "0000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

Verify at the official NPI Registry.