Individual provider Active NPI

Melissa A Veneracion, PA-C

  • Physician Assistant
  • Annapolis, MD
National Provider Identifier
1427263102
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0002907 Issued in MD
Practice address
101 Ridgely Ave
Suite 10
Annapolis, MD 21401-1409
Phone
(410) 263-5439
Fax
(410) 263-7482
NPI assigned
May 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0002907 MD Primary

Addresses

Primary practice location

101 Ridgely Ave
Suite 10
Annapolis, MD 21401-1409

Mailing address

101 Ridgely Ave
Suite 10
Annapolis, MD 21401-1409
Phone (410) 263-5439

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070815000465 MD Practitioner - Physician Assistant 8224120654 Reassigns benefits to 1 organization
I20180220002011 DC Practitioner - Physician Assistant 8224120654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Dermatology of Maryland PCGroup PAC ID 9931489804, 43 clinicians

Practice addresses (Care Compare)

101 Centennial St
Suite H
La Plata, MD 20646-5976
Phone (301) 292-6010

174 Waterfront St
Suite 200
Oxon Hill, MD 20745-1164
Phone (240) 493-8447

2401 Research Blvd
Suite 260
Rockville, MD 20850-3261
Phone (301) 990-6565

7505 Osler Dr
Suite 308
Towson, MD 21204-7738
Phone (410) 472-0901

Merit-based Incentive Payment System (MIPS)

Final score
83.97 of 100Reported as group
Quality
78.47
Promoting interoperability
83
Improvement activities
40
Cost
82.27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C0002907MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Dermatology of Maryland PC CurrentSince Sep 25, 2019 Accepting new patients
Advanced Dermatology of Maryland PC CurrentSince Jun 15, 2019 Accepting new patients
Advanced Dermatology of Maryland PC Past Accepting new patients

Locations

151 Southhall Ln
Ste 300
Maitland, FL 32751
Phone (407) 917-7293

11701 Livingston Rd
Ste 302
Ft Washington, MD 20744
Phone (301) 292-6010

101 Centennial St
Ste H
La Plata, MD 20646
Phone (301) 292-6010

174 Waterfront St
Ste 200
Oxon Hill, MD 20745
Phone (240) 493-8447

2401 Research Blvd
Ste 260
Rockville, MD 20850
Phone (301) 990-6565

7505 Osler Dr
Ste 308
Towson, MD 21204
Phone (410) 296-1464

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": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427263102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 RIDGELY AVE",
            "address_2": "SUITE 10",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214011409",
            "telephone_number": "410-263-5439",
            "fax_number": "410-263-7482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 RIDGELY AVE",
            "address_2": "SUITE 10",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214011409",
            "telephone_number": "410-263-5439",
            "fax_number": "410-263-7482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENERACION",
        "first_name": "MELISSA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0002907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.