Individual provider Active NPI

Melinda Holliday, MD

  • Pediatrics Physician
  • Bastrop, TX
National Provider Identifier
1346352408
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
N8520 Issued in TX
Practice address
622 W State Highway 71 Ste 102
Bastrop, TX 78602-4234
Phone
(512) 308-4311
Fax
(512) 406-7327
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 232546 NY
Pediatrics Physician 208000000X MA08333300 NJ
Pediatrics Physician 208000000X N8520 TX Primary

Addresses

Primary practice location

622 W State Highway 71 Ste 102
Bastrop, TX 78602-4234

Mailing address

622 W State Highway 71 Ste 102
Bastrop, TX 78602-4234
Phone (512) 308-4311

Other identifiers 2

IdentifierTypeStateIssuer
214713404MedicaidTX
214713403MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20110921000068 TX Practitioner - Pediatric Medicine 7810168952 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Austin Regional Clinic PAGroup PAC ID 3072507789, 398 clinicians

Practice addresses (Care Compare)

4100 Everett
400 Arc Kyle
Kyle, TX 78640-6147
Phone (512) 295-1333

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA08333300NJMDPediatrics Physician
232546NYMDPediatrics Physician
N8520TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Regional Clinic, PA CurrentSince Mar 28, 2019 Accepting new patients
Austin Regional Clinic, PA Pediatrics CurrentSince Mar 28, 2019 Accepting new patients

Locations

6835 Austin Center Blvd
Austin, TX 78731
Phone (512) 231-5210

6210 E Highway 290
Ste 420
Austin, TX 78723
Phone (512) 338-3802

6210 E Highway 290
Austin, TX 78723

622 W State Highway 71
Ste 102
Bastrop, TX 78602
Phone (512) 308-4311

151 Exchange Blvd
Ste 500
Hutto, TX 78634
Phone (512) 846-1244

4100 Everett
Ste 400
Kyle, TX 78640
Phone (512) 295-1333

Interoperability endpoints

  • Direct secure messaging: mholliday21059@arcmd.direct-ci.com

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": "1668729600000",
    "number": "1346352408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 W STATE HIGHWAY 71 STE 102",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786024234",
            "telephone_number": "512-308-4311",
            "fax_number": "512-406-7397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W STATE HIGHWAY 71 STE 102",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786024234",
            "telephone_number": "512-308-4311",
            "fax_number": "512-406-7327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIDAY",
        "first_name": "MELINDA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "232546",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "MA08333300",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "N8520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "214713404",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "214713403",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bastrop, TX

Sources for this page

Verify at the official NPI Registry.