Melissa Jenna Andrews, MD
Individual provider Active NPI Family Medicine Physician · Waterloo, IA
NPI 1336833540 · NPPES record last updated Jun 8, 2023
Key facts
- NPI
- 1336833540
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- R-12832 (IA)
- Practice address
- 2055 Kimball Ave Ste 101
Waterloo, IA 50702-5047 - Phone
- (319) 272-2112
- NPI assigned
- Jun 8, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230804003480 | IA | Order and Referring Only - Family Practice |
2264893338 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R-12832 | IA | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | R-12832 | IA | Yes |
Addresses
Primary practice location
2055 Kimball Ave Ste 101
Waterloo, IA 50702-5047
Mailing address
15042 115TH Dr
Jamaica, NY 11434-1502
Phone (347) 869-9915
Other providers in Waterloo, IA
- Andresen Counseling and Consulting LLC
- Eric Andresen
- Joyce M Andresen
- Andrew Jolley PC
- Levi Edward Andrews
- Richard Dwayne Anfinson
- Annie M. Kontos, P.C.
- Rajeev Anugu
- Seema Siddiq Arab
- Josephine Lynn Arganbright
All providers in Waterloo, IA · Family Medicine Physician in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.