Individual provider Active NPI

Melissa Jessica Victor, MD

  • Family Medicine Physician
  • Saginaw, MI
National Provider Identifier
1386174308
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301113078 Issued in MI
Practice address
3875 Bay Rd Ste 2N
Saginaw, MI 48603-2423
Phone
(989) 583-5300
NPI assigned
Jun 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301113078 MI Primary

Addresses

Primary practice location

3875 Bay Rd Ste 2N
Saginaw, MI 48603-2423

Mailing address

1447 N Harrison St
Saginaw, MI 48602-4727
Phone (989) 583-0000

Other practice location 1

1000 Houghton Ave
Saginaw, MI 48602-5303
Phone (989) 583-6800

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200702001453 MI Practitioner - Family PracticePractitioner - Emergency Medicine 9032489364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Powerback Rehabilitation LLCGroup PAC ID 2365359932, shared by 106 NPIs, 600 clinicians
Covenant Medical Center, Inc.Group PAC ID 2769387778, 488 clinicians

Practice addresses (Care Compare)

255 Mayer Rd
Frankenmuth, MI 48734-1358
Phone (989) 349-0016

3875 Bay Rd
Suite 2N
Saginaw, MI 48603-2423
Phone (989) 583-5300

Hospital & facility affiliations

  • Covenant at Home Home health agency, Saginaw, MI, CCN 237431
  • Covenant Medical Center Hospital, Saginaw, MI, CCN 230070

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301113078MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Center, Inc Family Medicine CurrentSince Jul 1, 2020 Accepting new patients
Covenant Medical Center, Inc. Current Accepting new patients

Locations

1447 N Harrison St
Saginaw, MI 48602
Phone (989) 583-4220

3875 Bay Rd
Ste 2N
Saginaw, MI 48603
Phone (989) 583-5300

Interoperability endpoints

  • Direct secure messaging: mvictor49030@direct.covenanthealthcare.com

Organizations & group practices 2

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 2

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": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1386174308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1447 N HARRISON ST",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486024727",
            "telephone_number": "989-583-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3875 BAY RD STE 2N",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486032423",
            "telephone_number": "989-583-5300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Houghton Ave",
            "address_purpose": "LOCATION",
            "city": "Saginaw",
            "state": "MI",
            "postal_code": "486025303",
            "country_code": "US",
            "telephone_number": "989-583-6800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VICTOR",
        "first_name": "MELISSA",
        "middle_name": "JESSICA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-13",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301113078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

Verify at the official NPI Registry.