Individual provider Active NPI

Melissa N Sirleaf, PA-C

  • Medical Physician Assistant
  • Austin, TX
National Provider Identifier
1396070850
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9104354 Issued in FL
Practice address
825 E Rundberg LN Ste B1
Austin, TX 78753-4860
Phone
(954) 253-9611
NPI assigned
Oct 15, 2009
Last updated
Jul 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA16241 TX
Medical Physician Assistant 363AM0700X PA9104354 FL Primary

Addresses

Primary practice location

825 E Rundberg LN Ste B1
Austin, TX 78753-4860

Mailing address

825 E Rundberg LN Ste B1
Austin, TX 78753-4860
Phone (954) 253-9611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA16241TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Central Texas Community Health Centers Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1255564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1396070850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 E RUNDBERG LN STE B1",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787534860",
            "telephone_number": "954-253-9611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 E RUNDBERG LN STE B1",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787534860",
            "telephone_number": "954-253-9611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRLEAF",
        "first_name": "MELISSA",
        "middle_name": "N",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-15",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA16241",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9104354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.